Prescription Drug Coverage Updates Taking Effect July 1, 2022
CVS Caremark™, NRECA’s pharmacy benefit manager, has announced changes to NRECA’s Medical Plan prescription drug coverage that will take effect July 1, 2022.
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.
Below is a list of updates. Note: Brand products are in all caps and generic products in lowercase italics.
CVS Caremark will mail a letter by June 1 to participants affected by the following updates:
- Removed from the formulary and added to the Medications Requiring Prior Authorization List: AFINITOR, CAYSTON, CITRANATAL VITAMINS, DEXILANT, DEXLANSOPRAZOLE, DUOBRII, ETONOGESTREL, ELURYNG, GLUCAGON EMERGENCY KIT, GLUCAGEN HYPOKIT, JUXTAPID, KEPPRA, KEPPRA XR, KORLYM, LAMICTAL, LAMICTAL CHEWABLE, LAMICTAL ODT, LAMICTAL STARTER KITS, LAMICTAL XR, MEKINIST, MOVANTIK, OPZELURA, PENTASA, QUILLICHEW ER, QUILLIVANT XR, TAFLINAR, VUITY
- Moved from tier 2 (preferred) to tier 3 (nonpreferred): See the list of medications on the NRECA Employee Benefits website; this unusually large number of tier changes allows NRECA to continue to provide competitive plans while managing rising prescription drug costs.
- Removed from the Preventive Drug List: amlodipine/valsartan/hydrochlorothiazide, BUNAVAIL, MINITRAN, MONONINE, PRINIVIL, TARKA, TWYNSTA
- Excluded from the formulary: ABSORICA, ABSORICA LD, DARTISLA, DEXTENZA, JUBLIA, LIVALO, SEGLENTIS, SOAANZ, XYOSTED
Additional updates:
- Added to the Performance Drug List (commonly prescribed drugs): APTIOM, AURYXIA, AZSTARYS, BRAFTOVI, CAPLYTA, COTELLIC, ENSTILAR, JORNAY PM, MEKTOVI, NUVARING, TALICIA, ZEGALOGUE, ZELBORAF
- Removed from the Medications Requiring Prior Authorization List to tier 3 (nonpreferred): LUPRON DEPOT
- Moved from tier 3 (nonpreferred) to tier 2 (preferred): See the list of medications on the NRECA Employee Benefits website.
- Added to the Preventive Drug List: APRETUDE, TEZSPIRE
- A quantity limit will be required on the following specialty drugs: BESREMI, ENJAYMO, LIVMARLI, LIVTENCITY, NUPLAZID, OXBRYTA, PYRUKYND, SCEMBLIX, TAVNEOS, UPLIZNA, VEKLURY, VONJO, VYVGARY, WELIREG
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 listed in this article until July 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 July 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.