Pharmacy Vendor Change Effective January 1, 2006

December 23, 2005

Dear Subscriber:

FirstCarolinaCare (FCC) is very pleased to announce that, effective January 1, 2006, our pharmacy benefit manager will change from Medco to MedImpact. We believe that this switch will result in better service and features for you. FCC's goal is to make this change as convenient as possible for our members. The FCC formulary will continue to have three tiers with the same benefit levels as what you have today, although a few drugs may change from one tier to another.

New features:

Walgreens added to the retail network: The MedImpact retail pharmacy network will include Walgreens, which was not in the Medco network.
90-day supply available at selected local pharmacies: FCC is also adding a new option with MedImpact called Choice 90, which will allow you to obtain a 90-day supply of maintenance medications from selected pharmacies.
Mail order now through Walgreens: If you are currently using the Medco mail order option for your maintenance medications, you will need to use the enclosed mail order document along with a new prescription from your provider to set up your mail order drug(s) with Walgreens, which will be the new mail order vendor through MedImpact.
Prilosec ® and Claritin OTC ® (Over-the-Counter) drugs now covered at the 1st Tier level with valid prescription.

New ID cards:

FCC will issue you a new ID card with the MedImpact information for your pharmacy to use. We will mail you a new ID card by the end of December. If you do not receive your new card by January 1, 2006, show this letter to your pharmacy, which can use the MedImpact information listed at the bottom of this letter along with your current FCC ID card (to get your member number) to submit your claim to MedImpact. If your pharmacy does submit your claim to Medco after January 1, 2006, it will be denied with a message from MedImpact asking the pharmacy to resubmit the claim to MedImpact.

Prior authorizations:

If you currently have a prior authorization for a drug, Medco has provided this information to MedImpact so that the prior authorization will be continued. If you do experience a problem when you get your next refill in January, please call one of the telephone numbers below for assistance.

While FCC has tried to keep the formulary and the prior authorization process with MedImpact as similar to the one used by Medco as possible, there may be some changes where a drug may change from tier 2 to tier 3 or from tier 3 to tier 2. If this occurs, please make sure you discuss your alternatives with your physician to determine if there are lower cost options. FCC will distribute a printed version of the revised FCC formulary as soon as possible.

If you have any questions, please call us toll-free at (800) 574-8556 or locally at (910) 715-8100. Feel free to visit www.medimpact.com after January 1, 2006.

Sincerely,
Kenneth J. Lewis
President

You may not have your new health insurance card by January 1, 2006
To use your pharmacy benefits prior to receiving your new card, please present your card to the pharmacy and give them the following MedImpact Information:
BIN # 003585 / PNC # 34400