NRECA Employee Benefits Weekly

Prescription Drug Coverage Updates Taking Effect January 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 January 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.

CVS Caremark will mail a letter before December 1 to participants affected by these updates:

  • Removed from the formulary and added to the Medications Requiring Prior Authorization list: ALREX, ASMANEX HFA, AVONEX, BEAU RX, BUTRANS, CARAFATE, COMBIVENT RESPIMAT, COMPLERA, DUROLANE, ENLITE CONTINUOUS GLUCOSE MONITORING SYSTEM, EPICERAM, FLAREX, FREESTYLE LIBRE CONTINUOUS GLUCOSE MONITORING SYSTEM, GUARDIAN CONNECT CONTINUOUS GLUCOSE MONITOR SYSTEM, HYSINGLA ER, KAMDOY, LO LOESTRIN FE, LOTEMAX, MINILINK REAL-TIME TRANSMITTER, MINIMED 3 CONTINUOUS GLUCOSE MONITOR LINK TRANSMITTER, MOVIPREP, NATAZIA, ORTHO D, OSMOPREP, OXYCONTIN CR, OXYCONTIN ER, PLEGRIDY, PROAIR HFA, QTERN, RECEDO, SIL-K PAD, SIMPONI, STRIBILD, TAYTULLA, TIMOPTIC, TRANSDERM SCOP, VERZENIO, ZOHYDRO ER, ZYLET
  • Moved from tier 2 (preferred) to tier 3 (nonpreferred): ABSTRAL, DICLEGIS, GLASSIA, LUPRON DEPOT PEDIATRIC, PEGINTRON, REYATAZ, TARCEVA, TRACLEER, ARALAST NP, ELIDEL, LETAIRIS, NEXAVAR, RETIN-A MICRO, SAFYRAL, TEKTURNA, VIREAD

Visit the Employee Benefits website for a complete listing of the updates taking effect January 1.

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 January 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.

On January 8, 2020, benefits administrators will receive a Message Center notification directing them to either a medical plan summary of material modifications or a new medical summary plan description describing the updates 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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