AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |
Back to Blog
Prescription pill look up11/6/2023 ![]() Look for a checkmark in the “Specialty drug” box or take a look at the Specialty Drug Program Member Guide (PDF). Specialty drugs: When you have a chronic or difficult health condition, you may need a specialty drug that requires special handling, monitoring or approval to order.For a list of drugs that have quantity limits, view our Quantity Limit Program Drug List (PDF). If your medication has a quantity limit, it will have (QL) after the name or a checkmark in the “Quantity limit” box. Quantity limits (QL): Many types of drugs are limited to a certain amount within a given timeframe.For more information, take a look at our prior authorization FAQs. Look for an indicator that your medication needs prior approval, such as (PA) after the name or a checkmark in the “Approval needed” box. Prior authorization (PA): We need to review certain drugs before your plan will cover them in order to make sure they are the right drug for your situation.For example, you’ll find Prilosec under “Gastrointestinal agents.” Drug lists typically group medications according to the condition they treat or what they are used for.Not every insurance plan has the same drug list, but there are a few things you should look for no matter which drug list applies to your plan. Tier 5 has the highest copayment for specialty drugs. Tier 5 - Nonpreferred Specialty: In Tier 5 are nonpreferred specialty drugs that likely have a more cost-effective generic or preferred alternative available.These drugs are generally more effective and less expensive than other specialty drugs. ![]()
0 Comments
Read More
Leave a Reply. |