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Announcement: Pharmacy Benefit Coverage Update – Effective May 1, 2020 & July 1, 2020 – UnitedHealthcare Commercial Plans

The original pharmacy formulary for UHC Commercial Pharmacy Benefits Plans was scheduled to take place on May 1,2020.

However, due to the current circumstances UHC revised their Pharmacy Benefits update and pushed it to become effective on July 1,2020.

According to UHC statement the change was done: “…to allow additional time for you and your patient to discuss alternative therapies when appropriate…”

This change applies to the following medications:

1. Diabetes-Insulin: Basaglar KwikPen, Levemir, Levemir FlexTouch and Tr

a. Lantus, Lantus SoloSTAR, Toujeo Max SoloSTAR and Toujeo SoloSTAR are currently excluded but will be added to the coverage on July 1,2020

2. Diabetes- Non-Insulin: Janumet, Janumet XR and Januvia

3. Neuromuscular Disorders: Firdapse

Step Therapy for Zomig will be required effective July 1,2020

Asthma- Arnuity Ellipta, Flovent Disus, Flovent HFA and Pulmicort Flexhaler will be covered at this time until further notice. However, these medications are still on tier 3 for UHC commercial Plans pharmacy benefit plans.

Since there are multiple prescription drug lists exist, please feel free to refer to patient-specific information received through e-prescribing or UHC PreCheck MyScript tool on Link.

Author:

My name is Kate Patskovska, CPB. I am an Independent Medical Biller CPB (AAPC) and an owner of KR2 Medical Billing. KR2 Medical Billing is a full service Consulting/Medical Billing Business that is dedicated to educating, consulting, and overall improving the "financial health" of your medical practice.

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