Healthcare Providers

Pharmacy

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During this unprecedented time, it may be more challenging for members to see their prescribers. In order to prevent gaps in therapy, we are extending clinical prior authorizations for drugs covered under the pharmacy and medical benefit due to expire by June 30, 2020 for 90 days. No action is needed by the member or provider. Prior authorizations will not be extended for certain drug classes such as opioids, Hepatitis C, dermatologicals, and hypnotics. Providers can view prior authorization expiration dates in the Provider Portal.

To manage drug supplies in the marketplace, quantity limits are applied to the following medications when used as treatment for COVID-19:

Members are not impacted if they are currently taking these medications or use the medications to treat lupus, rheumatoid arthritis or HIV. The quantity limits help ensure members with ongoing needs can maintain access to these medications, while also enabling patients with COVID-19 to obtain treatment.

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