What is the plan transition process for enrollees who are prescribed a non-formulary medication?
As a new or continuing member in our plan, you may be taking drugs that are not on our drug list. Or, you may be taking a drug that is on our drug list but your ability to get it is limited. For example, you may need a prior authorization from the plan before you can fill your prescription. You should talk to your doctor to decide if you should switch to an appropriate drug that is covered or request a formulary exception so that the plan will cover the drug you take. While you talk to your doctor to determine the right course of action for you, your drug may be covered in certain cases during the first 90 days you are a member of our plan. For each of your drugs that is not in the plan’s drug list, or if your ability to get your drugs is limited, the plan will cover a temporary 31-day transition supply (unless you have a prescription written for fewer days) when you go to a network pharmacy. Transition supplies are limited to one fill during the first 90 days you are a member of our p
Related Questions
- Is there an appeal process that allows enrollees to obtain benefits for a drug excluded from the Empire Plan Flexible Formulary?
- What is the plan transition process for plan members who are prescribed a non-formulary medication?
- What is the plan transition process for enrollees who are prescribed a non-formulary medication?
