Of the prescription drugs that are currently covered, which drugs would be excluded from the proposed drug benefit?
None, all are included in the proposed drug benefit; the only change is that you may have to pay a higher copay for certain drugs. Q: Im concerned that the brand name drugs I take will all be in the non-preferred category with the highest copay. A: An analysis of the 25 most frequently prescribed drugs used by PS&T unit Empire Plan enrollees showed that 23 were in the preferred category, one was in the non-preferred category, and one had converted to over-the-counter and therefore was no longer available as a prescription. The majority of drugs in the non-preferred category are brand name drugs for which a generic equivalent has been approved by the FDA. Currently, the Empire Plan has a mandatory generic substitution requirement, which requires the enrollee to pay the difference in cost between the brand name and generic drug, in addition to the copay. That requirement will continue. (Note: the PS&T data on most frequently prescribed drugs were aggregate (group) data with no informatio
Related Questions
- Of the prescription drugs that are currently covered, which drugs would be excluded from the proposed drug benefit?
- How does the new prescription drug benefit affect the care of older adults currently covered under Medicare?
- Is Specialty Pharmacy Medical Mgmt (SPMM) reviewing for drugs covered under the pharmacy benefit?
