Prescription Drug Coverage Updates Planned for 2019
CVS Caremark™, NRECA’s pharmacy benefit manager, has announced changes to the NRECA Medical Plan’s prescription drug formulary, effective January 1, 2019.
CVS Caremark continually reviews and updates the formulary to help ensure NRECA participants have access to safe, reliable and affordable prescription drugs.
Changes affecting participants’ costs
The following products will move from Tier 2 (preferred) to Tier 3 (nonpreferred) within the formulary, which may affect a participant’s copay or coinsurance amount.
- Zoledex, Welchol tablet, Ixinity, Fentora tablet, Benefix
The following products will be removed from the formulary because they may have less convenient dosage forms, more side effects or cost more compared to alternative options on the CVS Caremark Drug List.
- Benzaclin gel, Veltin, Ziana, Eloctate, Acticlate, Targadox, Zuplenz, Tirosint, Acanya, Onexton, Prolastin-C, Zemaira, Jentadueto, Jentadueto XR, Tradjenta, Norditropin, Cambia powder, Contrave, Fasenra, Invokana, Invokamet, Invokamet XR, OneTouch products, Sorilux, Vanatols, Avenova, Alprolix
CVS Caremark will send a letter to participants affected by these changes by December 1st.
Coverage changes to diabetic devices, test strips
Effective January 1, 2019, Accu-Chek® blood glucose monitoring devices and test strips will replace OneTouch® as preferred diabetic supplies under NRECA’s prescription drug benefit. However, a coverage grace period will be extended through March 31, 2019, for participants who have current prescriptions for OneTouch products. Effective April 1, 2019, participants may be responsible for paying the full price for OneTouch products.
Updated drug lists available
The updated lists of covered prescription drugs that go into effect January 1, 2019, are available on the Employee Benefits website. They include:
- Medications Requiring Prior Authorization
- Performance Drug List, which contains the most commonly prescribed brand and generic drugs covered by NRECA’s prescription drug benefit. 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 December instructing benefits administrators to download and distribute the supplemental medical plan summary of material modifications to plan participants.
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.