Medicare AdvantageAdministrativeMedium impact
2025 July Network Connection
Presbyterian Health Plan·NM · Pharmacy·Provider News
Effective date
Aug 1, 2025
We identified it
Jul 1, 2025
Summary
Presbyterian is transitioning its mail-order prescription service from Optum Home Delivery to Costco Pharmacy effective August 1, 2025, for non-specialty medications only. Members must enroll with Costco Pharmacy to continue receiving mail-order prescriptions, and no Costco membership is required. Providers can begin sending prescriptions to Costco Pharmacy Mail Order immediately via electronic or fax submission.
Action Required
By August 1, 2025: Billing and clinical staff must update prescription routing protocols to direct all non-specialty mail-order prescriptions to Costco Pharmacy Mail Order #1348, ZIP code 47130 (electronic submission) or fax 1-877-258-9584 instead of Optum Home Delivery. Update EMR/practice management system prescription templates and provider education materials with new Costco submission details. Notify prescribers that specialty medications continue through existing channels unchanged. Communicate with patients currently using Optum mail-order that they must enroll with Costco Pharmacy to avoid prescription delivery interruptions. Verify that billing system does not require Costco membership verification for member eligibility.