NRECA Employee Benefits Weekly

Prescription Drug Coverage Updates Taking Effect April 1, 2020

Posted on Posted in Group Benefits

CVS Caremark™, NRECA’s pharmacy benefit manager, has announced changes to NRECA’s Medical Plan prescription drug coverage. These changes will take effect April 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.

Note: Of the following changes, 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 March 1 to participants affected by these updates:

  • Removed from the formulary and added to the Medications Requiring Prior Authorization list: Activite, acyclovir cream 5%, ATOPADERM, Carbinoxamine tablet 6 mg, chlordiazepoxide clidinium, CICATRACE PAD, cyclobenzaprine 7.5mg tablet, dexchlorpheniramine, ENTERAGAM, Fexmid 7.5mg tablet, Folvite-D, ketoconazole foam 2%, Ketodan aerosol 2%, ketoprofen ext-rel capsule, lanthanum carbonate, Lactulose pak, Migergot, NICADAN, NICOMIDE, POLYTOZA, PRODIGEN, RyClora, SCARSILK MIS PAD, SILIVEX, SILTREX, VEREGEN, Vitasure, ZONTIVITY
  • Moved from tier 2 (preferred) to tier 3 (nonpreferred): LYRICA

Additional updates include:

  • Added to the Performance Drug List (commonly prescribed drugs): buprenorphine transdermal, fenofibric acid delayed-rel, ketoconazole shampoo 2%, mesalamine delayed rel capsule, pregabalin, ramelteon, selenium sulfide lotion 2.5%, triamterene, vancomycin capsule
  • Moved from tier 3 (nonpreferred) to tier 2 (preferred): SAVELLA
  • Added to the Preventive Drug List: aspirin/omeprazole delayed-rel, budesonide/formoterol, SECUADO, VUMERITY
  • A quantity limit will be required on the following specialty drugs: INBRIJA, IRESSA, PIQRAY, RUZURGI, SKYRIZI, VIGADRONE, VYNDAQEL, XPOVIO

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 described in this article until April 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 April 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.

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