Important Notice About Your Prescription Coverage

Updated: December 11, 2025

If You Received a Letter Saying Your Prescriptions Would No Longer Be Covered
We are aware that some patients with prescription insurance plans managed by the pharmacy benefit manager (PBM) Express Scripts received letters stating that, beginning January 1, 2026, their prescriptions would no longer be covered if filled by our pharmacy.

This information is incorrect
Our pharmacy remains in-network and maintains active contracts with:
  • Express Scripts
  • The insurance plans they administer
  • The assisted living and long-term care communities where our patients live
Your prescription coverage should not be interrupted.

Why did you receive this letter?
Across the country, PBMs have increasingly used notices like this to pressure long-term care (LTC) pharmacies into signing new or unfavorable network contracts. These notices often incorrectly suggest that a pharmacy is “out-of-network,” even when a valid contract is already in place.
In this case, our pharmacy appears to have been included in a broad PBM outreach related to 2026 contracting—despite the fact that our contract is active and despite PBMs knowing that LTC pharmacies have binding agreements with healthcare communities to provide specialized pharmacy services, including dispensing and delivery.

Federal guidance protects your access to care
On December 5, 2025, the Centers for Medicare & Medicaid Services (CMS) issued a formal reminder to Medicare Part D plan sponsors outlining their legal obligations, including:
  • Residents of long-term care facilities must have uninterrupted access to their contracted LTC pharmacy
  • PBMs cannot require residents to change prescription plans
  • Part D sponsors are expected to continue processing claims as in-network, even if a new contract has not been finalized
These protections are in place to prevent disruptions in medication access for patients like you.

Our commitment to you
Forum will continue providing all pharmacy services without interruption, including:
  • Timely prescription dispensing
  • Emergency and routine medication deliveries
  • Specialized packaging and medication management
  • Clinical support and pharmacist consultation
  • 24/7 access to pharmacy services
Your safety, continuity of care, and peace of mind remain our highest priorities. We are actively working with all involved parties to ensure seamless access to your medications despite these administrative tactics.

What Should You Do Next?
  • Do not change pharmacies or prescription plans based solely on this letter
  • Continue taking your medications as prescribed
  • If you receive additional notices suggesting non-coverage, plan changes, or service disruption, notify us immediately so we can assist you
We are here to advocate for you and to help ensure that inaccurate information does not interfere with your care.

Questions or Concerns?
Please contact Forum directly at (847) 673-8727 (press Option 2 from the main telephone menu), or email info@forumpharmacy.com, if you have questions about your coverage or if you receive any further communication from your insurance provider. We are happy to help.