Why is the Flexible Formulary being implemented?
The purpose of the Empire Plan Flexible Formulary is to reduce unnecessary costs without impacting clinically appropriate medication options for members and their physicians. This will be accomplished by: Excluding coverage for a small number of drugs; Placing brand-name drugs on the Empire Plan Flexible Formulary Drug List that provide the best overall healthcare value to the Plan; and Applying the highest copayment to non-preferred brand-name drugs that provide no clinical advantage over generic or preferred brand-name drug alternatives. Certain drugs are being excluded under the Empire Plan Prescription Drug Program so that the Plan can continue to provide the best value in prescription drug coverage to all enrollees under the Plan. Whenever a prescription drug is excluded, generic and/or therapeutically equivalent brand-name drug alternatives will be covered. By excluding coverage for a small number of drugs, the Empire Plan Flexible Formulary discourages the use of expensive “me-t
Related Questions
- Do current alternate workweeks need to be formally dissolved by the employer and a flexible schedule implemented, or will the alternate workweeks automatically be dissolved?
- How will enrollees using one of the medications being excluded from the Flexible Formulary Drug List, or being moved from Level 2 to Level 3, be notified?
- Why is the Flexible Formulary being implemented?
