Posted in In The Know Series, Insurance, Updates

UnitedHealthCare Commercial Plans: Pharmacy coverage for Taltz and Siliq coverage for 2020.

Posted on by KR2Medical Billing

Pharmacy Benefit change for UnitedHealthCare Commercial Plans– starting 01/01/2020-biologics Taltz and Siliq will no longer be COVERED (where state law allows) , for the UnitedHealthCare Commercial Plans.

The other preferred/covered biologics are:

Humira

Cimzia

Cosentyx

Simponi

Skyrizi

Stelara

Tremfya

 

*Please check out the pharmacy criteria for the coverage of these above mentioned biologics.

 

** The pharmacy WILL NOT automatically substitute Taltz or Siliq for the covered medications. Provider will need to write a NEW prescription and send it over to the pharmacy (to help reduce the out of pocket cost, for the patients).

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My name is Kate Patskovska, CPB. I am an Independent Medical Biller CPB (AAPC), AAPV Approved Instructor; and an owner of KR2 Medical Billing. I create educational material including blogs, presentations that focus on topics of medical billing, medical coding and reimbursement in healthcare.

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