Controlling healthcare costs and improving the lives of those affected by diabetes is a top priority for Independence Blue Cross (IBC). Therefore, IBC has selected two preferred insulin drugs, which will aid in controlling your costs while still providing members with access to effective medications.
WHAT THIS MEANS TO YOU AS AN EMPLOYEE?
These changes will affect you if all of the following are true:
• You are currently enrolled in your employer-sponsored health plan
• You use the IBC prescription drug program administered by FutureScripts
• If you or a family member, who is also under this plan, is diabetic.
Please read the important information below about these changes.
Preferred Brand of Insulin
Effective April 1, 2010, Novolin® and Novolog® will be the preferred insulin drugs for IBC prescription drug programs and Humulin®, Humalog®, ReliOn®/Novolin®, and Apidra® insulin will now be considered non-preferred for all programs. The FutureScripts Pharmacy and Therapeutics Committee, whose members include practicing physicians and pharmacists from the area, have determined that Novolin and Novolog are clinically equal to Humulin, Humalog, ReliOn/Novolin, and Apidra insulin in lowering blood sugar levels, which is a key clinical marker in diabetes management.
New Prior Authorization Requirement
Also, effective April 1, 2010, all newly prescribed non-preferred insulin will require prior authorization. If you or a family member is currently taking non-preferred insulin you do not have to obtain prior authorization until July 1, 2010. Prior authorization requests will be reviewed in accordance with IBC’s established criteria, and, if approved, non-preferred insulin will be covered at the appropriate cost-sharing level. If denied, non-preferred insulin will not be a covered benefit.
What Should You Do
Since it is essential for you or your family member to maintain insulin therapy, IBC is encouraging those who take Humulin, Humalog, ReliOn/Novolin, or Apidra to talk with their doctor to discuss which insulin is right for them. If your doctor writes a prescription for Novolin and/or Novolog, you will pay the appropriate copayment at participating retail pharmacies and through the mail order program, if applicable. If your doctor recommends that you continue using his or her current non-preferred insulin, they will be able to obtain this medication until June 30, 2010. After June 30, your doctor will need to complete a prior authorization form and receive approval from IBC for the member to continue to receive coverage for that brand of insulin medication.
You will be notified of these changes. If you are a member of the Select Drug Program and are affected by the insulin and/or other formulary changes you will be notified of the changes this Month. All other members, regardless of their drug coverage, taking a non-preferred brand of insulin through March 31 will receive a letter notifying them of the prior authorization requirement in May. These changes will also appear in the spring edition of Update magazine as well as online.
WHAT SHOULD I DO NEXT?
If you or a family member has questions about this notice please feel free to reach out to your BenefitsVIP team for assistance. As your employer’s broker, Corporate Synergies will continue to closely monitor this issue and will keep participants informed of any additional changes as they occur.
Corporate Synergies is pleased to provide regular updates on issues affecting group benefits insurance. As an insurance broker and consultant, Corporate Synergies is proactive in monitoring federal and state legislative and regulatory activity to ensure that you stay informed. Our customers call us their “Dedicated Advocates”. We work on your behalf. |
