Explore services across the health care journey

A pharmacy benefit manager (PBM) administers prescription drug benefits for employers and health plans. PBMs manage the formulary, negotiate manufacturer rebates, process prescriptions, and work with pharmacies to control drug costs while maintaining access to needed medications.

Specialty pharmacy supports complex, chronic, and rare conditions including oncology, autoimmune diseases (such as rheumatoid arthritis and multiple sclerosis), HIV, hepatitis C, and gene therapies. These conditions often require high-touch care, specialized medications, and dedicated clinical support.

By coordinating pharmacy and medical care, integrated services reduce duplicative treatments, prevent avoidable ER visits through virtual care, improve medication adherence, and optimize where care is delivered. This helps lower total healthcare costs—often by 15-20%—while improving member outcomes.

Pharmacy benefits cover prescription medications dispensed through pharmacies, while medical benefits cover clinical services such as doctor visits, hospital care, and procedures. Evernorth manages both to ensure coordinated, cost-effective care across the full health journey.

Evernorth works with employers, health plans, and consultants to design and deliver pharmacy, specialty, and medical care solutions tailored to each organization’s needs.

MD Live by Evernorth offers 24/7 virtual urgent care, behavioral health, and dermatology visits. Members can connect with licensed providers from anywhere, reducing unnecessary ER visits and expanding access to timely care.

Biosimilars are FDA-approved alternatives to biologic drugs that offer equivalent safety and efficacy at a lower cost. Evernorth’s formulary and specialty pharmacy programs help members access new biosimilar options, supporting affordability without compromising care quality.