NRECA Employee Benefits Weekly

Prescription Drug Coverage Updates Taking Effect July 1

Posted on Posted in Group Benefits

CVS Caremark™, NRECA’s pharmacy benefit manager, has announced changes to the NRECA Medical Plan’s prescription drug formulary, effective July 1, 2019.

CVS Caremark continually reviews and updates the formulary to help ensure NRECA participants have access to safe, reliable and affordable prescription drugs.

Here is a list of all coverage updates going into effect July 1. Note: Brand products are in all caps and generic products are in lowercase italics.

The following medication(s) will be:

  • Added to the formulary because they offer enhanced effectiveness and/or more convenient dosages compared to available options: NIVESTYM, UDENYCA
  • Moved from tier 3 (nonpreferred) to tier 2 (preferred) within the formulary, which may lower the copay and coinsurance cost: CIMDUO, EYLEA, LUCENTIS, NEULASTA, SYMFI, SYMFI LO, V-GO 40 KIT 
  • Added to the High-deductible health plan (HDHP) Preventive Drug List: aliskiren, INSULIN LISPRO, primaquine, VASCEPA, Wixela Inhub
  • Removed from the HDHP Preventive Drug List: CORZIDE, FIBRICOR, moexipril/hydrochlorothiazide, REGIMEX, SPRITAM

CVS Caremark will mail a letter on or before June 1 to participants affected by the following changes. These medications will be:

  • Moved from tier 2 (preferred) to tier 3 (nonpreferred) within the formulary, which may affect a participant’s copay or coinsurance amount: BROVANA, CANASA SUPPOSITORY, CIALIS, EPIVIR HBV SOL, MACUGEN, RAPAFLO, RAPAMUNE SOL, SANDIMMUNE, SAVELLA
  • Removed from the formulary (and added to the Medications Requiring Prior Authorization list) because they may have less convenient dosage forms, more side effects or cost more compared to alternative options on the CVS Caremark Drug List: BERINERT, FML LIQUIFLM, FOSTEUM PLUS, FOSTEUM, FULPHILA, GRANIX, RHEUMATE, VASCULERA, ZARXIO, ZORVOLEX

Updated drug lists available
Participants can visit the Prescription Drug page on the NRECA Employee Benefits website to view the most current version of the Performance Drug List. This list contains the most commonly prescribed brand and generic drugs covered by NRECA’s prescription drug benefit. Note: This list will not reflect the changes listed in this article until
July 1.

For drugs not on the Performance Drug List, participants can visit the Manage Your Prescriptions page to check on drug coverage, as well as the drug cost.

A Message Center notification will be sent in June instructing benefits administrators to download and distribute the supplemental medical plan summary of material modifications to plan participants outlining the changes listed in this article.

If you or your cooperative’s employees have questions about prescription drug coverage or these changes, call CVS Caremark Customer Care at 888.796.7322.

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