Part D Prior Authorizations, Coverage Determinations, and Exceptions If you would like to file an appeal, please call Express Scripts at 1-80, available 24 hours a day, 7 days a week. If you feel you were already charged incorrectly at the pharmacy, you can file an appeal to request reconsideration. Or ask your doctor if there's an acceptable alternate medication covered under our formulary. If Your Drug Isn't Listed For plan year 2023Ĭontact Express Scripts at 1-80 or TTY 1-80 to discuss options. To find your prescription drug within the formulary, search by your Plan & Drug name above. If the Food and Drug Administration deems a drug on our formulary to be unsafe, or the drug’s manufacturer removes the drug from the market, we’ll immediately remove the drug from our formulary and provide notice to members taking that drug. If we’re removing a drug from our formulary, we’ll either notify affected members 60 days prior to making that change, or notify them when they request a refill of that drug (at which time the member will also receive a 60-day supply of that drug). If we remove a drug from our formulary, add prior authorization for a drug, add quantity limits and/or step therapy restrictions on a drug, or move a drug to a higher cost-sharing tier, we must alert members taking that drug about those changes.
Plan Year 2023 Information Last Updated: 9:22:18 AM Planīrand New Day Bridges Care Plan (HMO C-SNP) 28īrand New Day Bridges Choice Plan (HMO C-SNP) 29īrand New Day Classic Care I Plan (HMO) 50-1īrand New Day Classic Care I Plan (HMO) 50-2īrand New Day Classic Care II Plan (HMO) 51-1īrand New Day Classic Care II Plan (HMO) 51-2īrand New Day Classic Care Plan III (HMO) 46īrand New Day Dual Access Plan (HMO D-SNP) 24īrand New Day Embrace Care Plan (HMO C-SNP) 47īrand New Day Embrace Care Plan (HMO C-SNP) 39-1īrand New Day Embrace Care Plan (HMO C-SNP) 39-2īrand New Day Embrace Choice Plan (HMO C-SNP) 40-1īrand New Day Embrace Choice Plan (HMO C-SNP) 40-2īrand New Day Part B Savings Plan (HMO) 49īrand New Day Select Care I Plan (HMO I-SNP) 42īrand New Day Select Care II Plan (HMO I-SNP) 43īrand New Day Select Choice I Plan (HMO I-SNP) 44īrand New Day Select Choice II Plan (HMO I-SNP) 45īrand New Day Valor Care Plan (HMO) 48 - Part B OnlyĮnglish | Spanish | Chinese Changes to Our Formularyīrand New Day may add or remove drugs from our formulary throughout the year. Refer to your Evidence of Coverage (EOC) for additional information on Part D Prescription Drug coverage or call Brand New Day Pharmacy Services. Prescribed medications are covered by the Plan as long as the drug is medically necessary and all plan rules are followed. The formulary represents the prescription therapies believed to be necessary in a quality treatment programs and was designed by Brand New Day in consultation with a team of healthcare providers. Part D prescription drugs are available through MedImpact Healthcare Systems large network of pharmacies.
Pharmacy and Formulary Specifics The formulary is a comprehensive list of Part D prescription drugs that are covered.
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