NRECA Employee Benefits Weekly

Prescription Drug Coverage Updates Taking Effect April 1, 2022

Posted on Posted in Group Benefits

CVS Caremark®, NRECA’s pharmacy benefit manager, has announced changes to NRECA’s Medical Plan prescription drug coverage that will take effect April 1, 2022.

Below is a list of updates. Note: Brand products are in ALL CAPS and generic products are in lowercase italics.

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

  • Removed from the formulary and added to the Medications Requiring Prior Authorization list: ALBUTEROL INH (NDC 66993001968 only), butalbital/acetaminophen, CAPSFENAC, DICLOFEX DC, doxycycline hyc dr, DYMISTA, EPANED, MYRBETRIQ, NUEDEXTA, prednisolone 10mg/5ml, prednisolone 20mg/5ml, SURE RESULT MIS DSS PACK, VTOL LG SOL, ZICLOPRO
  • Moved from tier 2 (preferred) to tier 3 (nonpreferred): BYSTOLIC,DUREZOL, SOLIRIS, SUTENT, FORTAMET (brand and generic equivalent), GLUMETZA (brand and generic equivalent), QUDEXY XR (brand and generic equivalent), TROKENDI XR (brand and generic equivalent)
  • Excluded from the formulary: FORTAMET (brand and generic equivalent), GLUMETZA (brand and generic equivalent), QUDEXY XR (brand and generic equivalent), TROKENDI XR (brand and generic equivalent)

Additional updates:

  • Added to the Performance Drug List (commonly prescribed drugs): GEMTESA
  • Moved from the Medications Requiring Prior Authorization list to tier 3 (nonpreferred): HAEGARDA
  • Added to the Preventive Drug List: EPRONTIA

Updated drug lists available
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.

Scroll to top