Prescription Drug Coverage Updates Taking Effect October 1, 2020
CVS Caremark™, NRECA’s pharmacy benefit manager, has announced changes to NRECA’s Medical Plan prescription drug coverage that will take effect October 1, 2020.
CVS Caremark continually reviews and updates drugs covered under the plan to help ensure NRECA participants have access to safe, reliable and affordable prescription drugs.
Below is a list of updates. Note: Brand products are in all caps, branded generics in upper and lowercase Italics, and generic products in lowercase italics.
CVS Caremark will mail a letter before September 1 to participants affected by the following updates:
- Removed from the formulary and added to the Medications Requiring Prior Authorization list: ALIQOPA VIA, APLENZIN, Bupap tab 50-300mg, butalb/acet tab 50-300mg, chlorzoxazone tab 500mg (NDC 73007001303 only), DaVite, Diphen Elixir, EVERSENSE MIS SENSOR, EVERSENSE MIS TRANSMITTER, FENOPROPHEN CAPSULE, fluoxetine tab (generics for SARAFEM only), Folvik-D, INDERAL LA, INDERAL XL, indomethacin cap 20mg, INNOPRAN XL, indomethacin cap 20mg, INNOPRAN XL, LETAIRIS, mefenamic acid (NDC 69336012830), methocarbamol 750mg (NDCs 69036093090, 7086809190 only), minocycline ext rel, MultiPro, MYTESI, niacin tab 500mg, Niacor, oxiconazole (NDCs 00168035830, 51672135902 only) quazepam, sucralfate suspension, ZORTRESS, ZYDELIG
- Moved from tier 2 (preferred) to tier 3 (nonpreferred): COMBIVENT, HALOG SOL, MOXEZA SOL, ONPATTRO SOL, SILENOR TAB, TRAVATAN Z SOL
- Removed from the Preventive Drug List: ADALAT CC, BELVIQ, BELVIQ XR, COLYTE (peg 3350/electrolytes),eprosartan, GLUCOPHAGE, GLUCOPHAGE XR, KHEDEZLA
Additional updates:
- Added to the Performance Drug List (commonly prescribed drugs): COPIKTRA, DOVATO TAB, GVOKE, TEGSEDI
- Added to the Preventive Drug List: LYUMJEV, ZEPOSIA
- A quantity limit will be required on the following specialty drugs: KOSELUGO, PEMAZYRE, QINLOCK, RETEVMO, TABRECTA, TUKYSA, ZEPOSIA
Updated drug lists available
The current Performance Drug List, which contains the most commonly prescribed brand and generic drugs, is available on the Prescription Drug page of the NRECA Employee Benefits website. Note that the Performance Drug List will not reflect the updates listed in this article until October 1. Participants can visit the Manage Your Prescriptions page to check on coverage and costs for drugs that are not on the Performance Drug List.
No later than October 1, benefits administrators will receive a Message Center notification directing them to a supplemental medical plan summary of material modifications (SMM) describing the changes listed in this article. The notification will also contain a link to distribution instructions and deadlines.
If you or your employees have questions about prescription drug coverage or about these updates, call CVS Caremark Customer Care at 888.796.7322.