Prescription Coverage - Provisions
 
Effective July 1, 2015, Temple University implemented some additional cost controls to our prescription plan.
  • Mandatory Mail Order for Maintenance drugs – Maintenance long term drugs that are used on a regular based and listed on CVS/Caremark’s Maintenance Drug List must be filled either through mail order or at a CVS pharmacy. Members will receive the discounted pricing of 3 months’ supply for the price of 2 months’ co-pay. Click here for the CVS/CareMark Maintenance Drug List
  • Generic Step Therapy –Generic alternatives, within the same therapeutic class, must be used as first line therapy before certain targeted brand drugs are covered. If you are using a brand drug, please discuss this new requirement with your physician to ensure that your drug is covered. Click here for the Generic Drug list.
  • Dispense as Written (DAW) 1 – If your health provider requires a brand drug when a generic substitution is available you will be charged a penalty in the amount of the difference in cost between the generic and brand drug plus your co-pay. This only applies when a multi-source brand medication is dispensed by physician or customer request over available generic equivalents. If you are using a brand drug, please discuss this new requirement with your physician to ensure that your drug is covered.
  • Exclusive Specialty – Employees taking specialty drugs may fill their script at a local CVS ONLY or have the physician send the prescription directly to the specialty pharmacy for home delivery. Click here for the Comprehensive Specialty Pharmacy Drug List.
Some or all of these provisions may not apply to select bargaining groups.
 
updated 07/14/2015

 

 
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