CVS Caremark Sending Letters on Prescription Drug Coverage Changes
CVS Caremark®, NRECA’s pharmacy benefit manager, has updated the list of drugs covered under NRECA’s prescription drug benefit for 2018. This list—called the Performance Drug List—contains the most commonly prescribed brand and generic drugs.
Effective January 1, 2018, the drugs removed from this list will no longer be covered by NRECA’s prescription drug program.
Participants who continue to use medication that has been removed from the Performance Drug List after December 31, 2017, may be responsible for paying the full cost.
CVS Caremark will send a letter in November to affected participants to inform them of the change.
Letters to participants using nonspecialty prescription drugs will identify a covered option to replace the current medicine and provide next steps for getting a new prescription. Letters to participants using specialty drugs will explain how CVS Specialty™ will work with the participant’s provider to identify an alternative option and acquire a new prescription.
Samples of the specialty prescription letter and nonspecialty prescription letter are posted on the Employee Benefits website.
Other coverage changes in 2018
Additionally, CVS Caremark will send separate letters in November to participants affected by the following changes taking effect January 1, 2018:
- Glumetza® and Fortamet®, brand and generic formulations, will require prior authorization effective January 1, 2018. The letter will provide an alternative medication.
- New quantity limits will apply for coverage of test strips related to diabetes care. Prior authorization is required for coverage of a quantity that exceeds the limits.
- New quantity limits will apply for coverage of lidocaine, commonly used for topical pain. Prior authorization is required for coverage of a quantity that exceeds the limits.
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.