Periodically changes are made to pharmacy benefit formularies. These changes are necessary as new medications enter the market, patents on older medications expire, and FDA guidelines are modified. These changes can affect prior authorization requirements, limitations placed on quantity limits based on FDA prescribing guidelines, movement between tiers i.e. moving from preferred to non-preferred status, and removing some medications that were previously covered to non-covered status. Many changes were implemented during January 2016 and MagellanRx identified the impact to our members through historical claims information. Letters to members were sent identifying the changes. Please refer to the documents below for a summary of the changes.
Moved From Covered to Non-Covered (Alternatives offered)
Implemented Prior Authorization Requirements and Quantity Limits
Moved Rx to Different Tier Change
Excluded Medications that are Available Over-the-Counter