Comparison of non sedating antihistamines
The medications in the table below will change tiers: The medications in the table below will change tier levels: Medication with New Quality Care Dosing Limit To make sure that the quantity and dose of a medication meets the Federal Drug Administration, manufacturer, and clinical recommendations, we are adding a Quality Care Dosing Limit to the following medications: Medication Class That Will Be a Benefit Exclusion Effective January 1, 2017, all inhaled nasal steroids used to treat allergies, in the therapeutic class, will be excluded from our pharmacy benefit coverage.
For more information about your prescription coverage, visit bluecrossma.com/pharmacy. Pharmacy Program Changes Coming in 2018 Beginning January 1, 2018, we're making changes to our covered medications list for medical plans with pharmacy benefits, and Medex®´ plans with the three-tier pharmacy benefit.
We're making this change because several products in this class are available over the counter.
New Prior Authorization Requirements for HMO, Access Blue, and Blue Choice Plans Beginning September 1, 2017, prior authorization is required for the medications listed below when administered: This change doesn't affect these medications when used in inpatient, surgical day care, urgent care centers, and ER settings.
There will be no impacted member communications Proton Pump Inhibitors Will Be Excluded from Pharmacy Coverage Beginning January 1, 2019, all proton pump inhibitors will be excluded from our pharmacy benefit coverage, except for members under the age of 18 and those taking combination medications to treat H. Formulary exceptions, including those previously approved, will no longer be available for this class of medication, except for members under the age of 18 and those taking combination medications to treat H. This change applies to all commercial plans, group Medex plans with three-tier pharmacy benefits, and Managed Blue for Seniors plans.
We will notify impacted members beginning in November 2018 prior to the change.
If you're already using this specialty pharmacy for any medication, no action on your part is required.