11/12/2009
Asuris TruAdvantageTM and Asuris Medicare Script formulary changes
We are removing approximately 75 medications from the Asuris TruAdvantage and Asuris Medicare Script formulary in 2010. All are either brand-names that have exact generic equivalents or brand-names with current formulary alternatives. We still cover 5,925 of the 6,000 Medicare Part D-covered medications.
While our intent was to "grandfather" current members on medications that we changed to non-formulary status, CMS has confirmed that plans that remove medications from their formulary must administer that formulary equally across all beneficiaries. CMS will not allow grandfathering of members on these non-formulary medications and will require us to apply standard transition processes.
For this reason, members can continue to receive these non-formulary medications only as provided through our standard transition process. We will notify members on non-formulary medications about how they may continue these medications (via the exceptions process) or switch to therapeutic formulary options.
This process allows us to comply with CMS guidelines while giving members an avenue for requesting coverage of non-formulary medications when medically necessary and/or encouraging them to save money with formulary options.
For additional details review our FAQ regarding the 2010 changes to our Asuris TruAdvantage or Asuris Medicare Script Formulary. If you have any questions, please talk to your Asuris Sales contact or Individual Marketing at 1-888-734-3623.
Note: To print a PDF document, you need Adobe® Reader®. Download it now for free.
« Back to Communications
|
