What is Carelon pharmacy?
“Carelon supports employers, plan sponsors, payers, and their members with pharmacy services in two areas: pharmacy benefit management and dispensing pharmacy services.”
Carelon
Carelon is a Health services company, subsidiary of Elevance Health (formerly Anthem).
Questions & answers
What is CarelonRx?
“CarelonRx brings pharmacy benefit management to Carelon’s capabilities as part of the Elevance Health family of healthcare services brands. As a PBM, CarelonRx focuses on pharmacy benefit strategy, clinical programs and solutions, drug lists, utilization management, and pharmacy network management. CarelonRx works to help improve access, control costs, and enhance health outcomes through integrated, whole-person pharmacy care.”
What is a dispensing pharmacy?
“A dispensing pharmacy is responsible for filling a prescription and providing the medicine to the member. In a pharmacy benefit, dispensing pharmacies may include retail, mail order, specialty, or other network pharmacies that help members access their therapies safely and appropriately. Carelon’s dispensing pharmacy partners support access to medications and therapies through specialty pharmacy, home delivery pharmacy, and infusion care.”
What is utilization management?
“Utilization management is an evidence-based approach that helps health plans evaluate the clinical appropriateness of care and services. It supports informed care decisions while helping improve quality, manage costs, and promote better experiences for members and providers.”
What is utilization review?
“Utilization review is the process of evaluating healthcare services to determine whether they are clinically appropriate and consistent with evidence-based guidelines. It is an important part of utilization management and helps support appropriate, high-quality care.”
What is medical benefits management?
“Medical benefits management helps health plans manage services covered under the medical benefit. Carelon combines clinical expertise, technology, and utilization management to support evidence-based care, streamline provider workflows, improve the member experience, and help manage healthcare costs.”
What does medical benefits management support?
“Medical benefits management can support a range of diagnostic, specialty, complex, and post-acute care needs. Carelon solutions span areas including radiology, cardiovascular care, sleep, surgical procedures, musculoskeletal care, rehabilitation, oncology, genetic testing, and post-acute care.”
Data formats & record details
Download this profile and inspect its supporting evidence.
- Entity ID
- urn:readyscan:entity:carelon-q114389300
- Material fingerprint
- fnv1a64:64d9cfed29f9e3b7
- Entity revision
- fnv1a64:d73083515dfa6770
- Published
- 2026-10-26
- Modified
- 2026-10-26
- Source summary
- Carelon: Health services company, subsidiary of Elevance Health (formerly Anthem). Website: https://www.carelon.com/
- Evidence record
- urn:readyscan:corpus:evidence:carelon-q114389300