14 April 2014

United Healthcare – Generic/Brand Status Changing for Certain Drugs

March 31, 2014

 

On July 1, 2014, a limited list of medications & products will experience a drug classification change and may increase in cost.

Due to a move from First DataBank to Medi-Span as the source for drug classification, these medications will have different indicators as a brand or generic drug, with a few moving to Over-The-Counter (OTC) status.  Most of these drugs will no longer be considered a generic product and the brand copay or coinsurance defined by your plan may apply.

  • For copay or coinsurance plans, members will generally pay a higher cost for medications if they are considered brand.
  • For high-deductible or consumer-driven health plans, the full cash price is not expected to change for members.  However, after members reach their deductible, the same pricing change may apply.

Less than five of these drugs are included in our top 500 most commonly used medications, published every January 1 and July 1 as part of our PDL updates.  A small number of these medications will become classified as OTC, and these lower -cost medications are typically excluded from pharmacy benefit coverage.

We continue to offer the highest value medications in the lowest tier possible, providing your employees options and flexibility.  Tier 1 is the lowest-cost option for your employees.

We will notify impacted members via letter 60 days in advance of the effective date.  Members will be informed they can learn more about lower-cost options by:

  • Call customer Service at the toll-free member phone number on the back of their health plan ID card.
  • Logging in to myuhc.com and choosing “Manage My Prescriptions” after July 1, 2014.