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Medication access for patients with underlying health conditions

Beginning March 21, 2020, fully insured members will be allowed to fill up to a 90-day supply of medication if, in the judgement of their physician or pharmacist, they should practice social distancing or remain quarantined for a long period of time. For self-funded customers who allow 90-day supply of medication, the process will be the same as fully insured. Without this benefit, they can still access up to a 30-day supply on an early refill.

 

We want to caution providers that there are existing supply chain issues with some medications. This option should be used only for those members with underlying health conditions that put them at greater risk.

 

Effective March 23, 2020, all prior authorizations for drugs that are due to expire before July will be extended through July to lessen the administrative burden on both pharmacies and provider offices.

 

We have also extended prior authorizations for prescription medications set to expire in the next 90 days through July 31, 2020.

 

Wellmark has also enacted an expedited process for pharmacists, which provides them the authority to enact a point of sale bypass on a member-by-member basis for any alternative drug that may be used when another drug is in short supply.


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