Prescription Drug Coverage Updates Taking Effect July 1, 2023

CVS Caremark™, NRECA’s pharmacy benefit manager, has announced changes to NRECA’s Medical Plan prescription drug coverage that will take effect July 1, 2023.

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 and generic products in lowercase italics.

CVS Caremark will mail a letter by June 1 to participants affected by the following updates:

• Removed from the formulary and added to the Medications Requiring Prior Authorization list: AUBAGIO, BANZEL, BETHKIS, DIACOMIT, DYANAVEL XR, FINTEPLA, FIRMAGON, FLOVENT HFA, JORNAY PM, JYNARQUE, KITABIS, LATUDA, LOKELMA, LOVAZA, LUMIGAN, MYDAYIS, PRALUENT, RENVELA, RHOPRESSA, ROCKLATAN, VEMLIDY, VIMPAT, VYZULTA, and all prescription brand multi-vitamins (ADRENAL C, BACMIN, DEXATRAN, DIALYVITE, DIALYVITE SUPREM D, DIALYVITE ZINC, FLORIVA, FOLGARD OS, INFUVITE, NEPHPLEX RX, NEPHROCAPS, NEPHRO-VITE, NUTRICAP, NUTRIVITE, OCUVEL, ONEVITE, POLY-VI-FLOR, PRO HERS RX, PRO HIS RX, PRO PCOS RX, QUFLORA, RENATABS, REQ 49+, SIDEROL, STROVITE, SUPERVITE, SUPPORT-500, THRIVITE 19, TRI-VI-FLORO, UDAMIN SP, VITAL-D RX, VITAROCA PLUS)
• Moved from tier 2 (preferred) to tier 3 (nonpreferred): ANDRODERM, BARACLUDE, CAPLYTA, PHOSLYRA SOL

Additional updates:

• Added to the Performance Drug List (commonly prescribed drugs): bimatoprost ophthalmic sol 0.03%, ARANESP, PROCRIT, REPATHA, ZEMAIRA
• Added to the Preventive Drug List: methyldopa, PRADAXA PAK
• A quantity limit will be required on the following specialty drugs: BRIUMVI, FILSPARI, JAYPIRCA, LUNSUMIO, ORSERDU, REZLIDHIA, SUNLENCA, SKYCLARYS

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, under Checking Coverage, on the NRECA Employee Benefits website. Note that the Performance Drug List will not reflect the updates listed in this article until July 1. Participants can visit the Manage Your Prescriptions page to check coverage and costs for drugs that are not on the Performance Drug List.

No later than July 1, benefits administrators will receive a Message Center notification directing them to a supplemental medical plan summary of material modifications 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.