I have questions about my insulin coverage?

Can my plan remove insulin products from their list of covered drugs during the year? Or add restrictions, like prior authorization or step therapy?

• Safety: If the FDA or other regulatory agency determines that a drug is unsafe or poses a significant risk to patients, the Part D plan may remove it from its formulary.
• Cost: If the cost of a drug increases significantly, the Part D plan may remove it from its formulary or place it on a higher cost-sharing tier.
• Efficacy: If a new drug becomes available that is more effective or has fewer side effects than a drug currently on the formulary, the Part D plan may remove the older drug from the formulary.

• Placing a drug in a lower cost-sharing level.
• Replacing a brand-name drug with a generic drug.
• Removing utilization management requirements.

The notice will explain how the changes will affect your coverage and provide information on alternative drugs that are covered by the plan. If you are not satisfied with the changes, you have the option to switch to a different Part D plan during the annual enrollment period (AEP) or during a special enrollment period (SEP) if you qualify.

MedHelpCenter.us recommends that you call the Senior Health Insurance Agency at 813-592-8568 for further explanation.