Pharmacy News
Published November 11, 2019
For producers who sell fully-insured and self-funded Premera group plans
Premera Blue Cross regularly reviews its pharmacy programs for effectiveness and value—including evaluating ways to improve the member experience. To bring better value to our customers and connect them sooner to the programs offered by our preferred specialty pharmacies, Premera is changing the way its mandatory specialty pharmacy benefit is applied in 2020.
Please refer to the following FAQ for information about changes to specialty pharmacy for 2020.
| Question |
Answer |
| What is changing? |
Starting January 1, 2020, as groups renew, the mandatory specialty benefit will no longer include two “grace fills” at a retail pharmacy. |
| How does this impact members? |
Members on a group plan with the mandatory specialty benefit will need to fill select specialty pharmacy prescriptions at a preferred specialty pharmacy.
- Members on plans with an exclusive specialty pharmacy network will need to use Accredo specialty pharmacy.
- Members on plans with a dual specialty pharmacy network will need to use Accredo or AllianceRx Walgreens Prime.
|
| Which specialty drugs does this change apply to? |
This change applies to specialty drugs found on the Mandatory Specialty Drug List |
| How will members be notified of this change? |
Impacted members were informed of this change in their annual “Changes to Your Benefits” notice. |
Action to take
Familiarize yourself with this change to the mandatory specialty benefit for 2020. If your clients have questions, please have them call Premera customer service.