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News about our Medicare Advantage formulary

11/29/2016

We're making some changes to our Medicare Advantage formulary effective Jan. 1, 2017. Please help support your patients affected by it.

We have notified members through their Annual Notice of Change communications and also plan to send them a letter telling them exactly how the changes will affect them. We're urging members to bring their formularies to you to make sure there's no disruption to their prescription treatments.

The changes to our formulary effective Jan. 1, 2017, will include:

  • Changing step therapy, preauthorization and quantity limits requirements,
  • Covering only generic versions of certain brand-name drugs,
  • Covering only drug alternatives of certain brand-name and generic drugs,
  • Moving drugs from one tier to another, or
  • Removing drugs from the formulary so they are no longer covered.

Whenever possible, please encourage your patients to take steps to help lower their prescription costs, including taking generics when possible and using home delivery from Express Scripts, our pharmacy benefit manager. They will listen to you.