New Preventive Drug Lists Are Available

  • Pharmacy News
    Published August 10, 2020

    The new preventive drug lists will take effect for new sales starting 1/1/21 and as groups renew for 2021.

    Premera Blue Cross recently improved and replaced our three standard preventive drug lists (PV1, PV2, PV3) with new and improved lists (PV Lite, PV Core, and PV Core Plus) which will better align with IRS guidelines outlined in the IRS 2019-45 notice.

    What changed?

    Certain mental health drugs, osteoporosis therapy, asthma inhalers, and insulin products are now covered under our three standard preventive drug lists: PV Lite, PV Core, and PV Core Plus. This means that these drugs are now provided to our members at no cost share.

    Our newly updated standard preventive drug lists are as follows:

    • PV Lite: A great option for your groups who are interested in achieving the most cost savings all the while still offering the minimum required preventive drug coverage.
    • PV Core: This list is replacing PV1 as the standard option for fully insured group plans. In addition to the minimum required preventive drugs, this list also covers certain blood thinning agents as well as certain cholesterol lowering agents.
    • PV Core Plus: This list offers our most robust coverage of drugs. In addition to the minimum required preventive drugs, PV Core Plus also covers additional drugs for behavioral health, hypertension, diabetes, and pulmonary care. This list already includes all the additional coverage offered in the add-on lists for PV Lite and PV Core.

    Additional coverage for PV Lite or PV Core lists

    Is your group client eligible for customization and want additional coverage for their PV Lite or PV Core list? Four add-on lists are available for drugs addressing the following care:

    • - Behavioral Health
    • - Hypertension
    • - Diabetes
    • - Pulmonary

    If you have any questions about the preventive drug lists offered by Premera, you may reach out to your Premera representative. Keep in mind, if your clients are interested in group-specific modelling of financial and member impact, these reports will be available in September 2020.

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