Pharmacy Updates
The information in this section applies to members of most employer group plans and individual members who have plans they purchased before the Affordable Care Act (ACA) became effective in 2013 (including Personal BlueSM, MSA and Mark IV plans). This information does not apply to members who use the Performance Drug List.
Most changes to our pharmacy programs and lists are made quarterly. Any member who is using a drug that is affected by a pharmacy program change will receive a letter that describes the change and outlines any action required by the member and/or their doctor.
Changes that trigger a letter include:
- A drug being excluded from the formulary (drug list)
- A drug moving to a higher copay tier
- A drug being added to a pharmacy program, such as Prior Authorization, Quantity Management or Step Therapy.