NRECA Employee Benefits Weekly

Prescription Drug Coverage Updates Taking Effect October 1, 2021

Posted on Posted in Group Benefits

CVS Caremark™, NRECA’s pharmacy benefit manager, has announced changes to the NRECA Medical Plan’s prescription drug coverage that will take effect October 1, 2021.

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, branded generics in upper and lowercase Italics, and generic products in lowercase italics.

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

  • Removed from the formulary and added to the Medications Requiring Prior Authorization list: betamethasone acetate-betamethasone sodium phosphate inj, calcipotriene foam, chlordiazepoxide/clidinium cap (NDCs 67877073101, 70700018501), CORDRAN, CORDRAN TAPE, doxycycline hyclate dr tab 100mg, HALOG, HEPARIN SODIUM IN 5% DEXTROSE, meloxicam cap, paroxetine tab er 37.5mg (ndc 60505367503 only), ULTRAVATE
  • Moved from tier 2 (preferred) to tier 3 (nonpreferred): AZOPT, DYMISTA, TRUVADA
  • Removed from the Preventive Drug List: captopril/hydrochlorothiazide, GLUCOTROL, phendimetrazine ext-rel, PROCARDIA, STARLIX

Additional updates:

  • Added to the Performance Drug List (commonly prescribed drugs): TAGRISSO TAB
  • Added to the Preventive Drug List: fenofibric acid, INSULIN ASPART, INSULIN ASPART 70/30 MIX, NOVOLOG RELION, NOVOLOG RELION 70/30 MIX, PHENDIMETRAZINE ER, PONVORY, ROSZET
  • A quantity limit will be required on the following specialty drugs: AMONDYS, CABENVA, EVKEEZA, HETLIOZ, ICLUSIG, IMCIVREE, LIBTAYO, LUMAKRAS, LUPKYNIS, NULIBRY, PLEGRIDY, RYBREVANT, SKYRIZI, TRUSELTIQ, UKONIQ, VOCABRIA, 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 listed in this article until October 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 October 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