CarelonRx is a pharmacy benefit manager (PBM) with a whole-health focus. This means we manage the pharmacy portion of healthcare benefits. Since we were launched by one of the nation’s largest health organizations, we have a deep understanding of both pharmacy and medical insights. This expertise helps us drive better health outcomes, lower costs, and simplify pharmacy experiences.
You can learn more about CarelonRx on our website, carelonrx.com, or by contacting us at carelonrxwebinars@carelon.com.
CarelonRx elevates healthcare primarily by making pharmacy services more affordable, accessible, and clinically guided. This approach increases the likelihood that individuals will start and remain on the appropriate medications. Affordability is built into the benefit, as EnsureRx automatically compares prices for hundreds of generic medications with various discount cards and applies the lowest available price at the register. Clinical criteria and coverage decisions are evaluated by an independent Pharmacy & Therapeutics (P&T) Committee. Additionally, CarelonRx collaborates with community pharmacies to address care gaps, and the Community Pharmacy Total Care (CPTC) model connects higher-risk Medicaid members with the support they need.
CarelonRx collaborates with other Carelon capabilities — like Carelon Behavioral Health and “Food as Medicine” — through a connected-care approach that aligns clinical programs and insights across medical, behavioral, and pharmacy. This helps identify care gaps sooner, coordinate interventions, and support whole-person outcomes, especially for members managing chronic or complex conditions.