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Currently there are two preferred brands of rescue inhaler for commercial
and Medicare Part D members, including ProAir HFA.
Effective October 1, 2013, AmeriHealth will designate
ProAir HFA as our only preferred brand of rescue inhaler for commercial
members. Medicare Part D members will not be affected by this change.
Commercial members who are currently prescribed a rescue inhaler were mailed
a letter notifying them of this change. The letter explained that in order for
other brands of rescue inhaler to be covered, prior authorization will be
required and, in some cases, members will pay a higher level of
cost-sharing.
Prescribing options for commercial members as of October 1, 2013:
- Prescribe ProAir HFA. ProAir HFA will continue to be
covered at the brand formulary level of cost-sharing. Prior authorization will
not be required.
- Prescribe a non-preferred rescue inhaler (i.e., other than ProAir
HFA). You will need to submit to FutureScripts? a prior
authorization request using the General Pharmacy form. In
some cases, members who are prescribed a non-preferred rescue inhaler will be
responsible for the highest nonformulary level of cost-sharing.
If
ProAir HFA is not prescribed, we strongly recommend that you allow additional
time for us to process the prior authorization request when writing a new
prescription.
If you have any questions, please contact FutureScripts at 1-888-678-7012.
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