In the last two weeks, we have received many reports from members of the Foreign Service Benefit Plan – both continuing members and those who joined this year – of problems utilizing the new EncircleRx program. This program applies to members covered by the High Option prescription drug benefits. It requires members who are prescribed a GLP-1 for weight management – namely, Wegovy and Zepbound – to enroll in either the Advanced Weight Management Program or the Advanced Pre-diabetes Program from Teladoc Health. Enrollment is required for the first fill of a prescription, and your prescriber must then provide an updated prior authorization to Express Scripts. For refills throughout the year, members must engage with the program by weighing in on the Teladoc-provided scale at least 4x per month and interacting with the app at least 4x per month by tracking activity, tracking meals, reading articles, having a coaching session, and more.
Unfortunately, the rollout of this program has not been seamless. Members have encountered a number of issues, ranging from simply enrolling in a Teladoc Health program to their enrollment appearing in the Express Scripts/Evernorth program, and challenges with their prescribers completing the required prior authorization. I sincerely apologize to everyone who has been impacted by this problem.
I have worked on little else in the last two weeks, and I will continue to focus on resolving the underlying issues causing these problems and addressing individual members’ needs. Multiple fixes have been implemented in recent days, and I anticipate continued improvement in the days ahead.
If you are facing an imminent refill and are having trouble doing so, please contact our office by email at presentation@afspa.org or by phone at (202) 833-4910, and we will follow our process to resolve the issue for now. Participation in the program will still be required going forward.
Our members trust us to meet their needs. I regret that we have not met your expectations in this instance. We will continue to improve, hold our partners accountable, and do our utmost in caring for your health worldwide.
