Effective July 1, 2018, AmeriHealth Pennsylvania will update its list
of specialty drugs that require member cost-sharing (i.e., copayment,
deductible, and coinsurance). Cost-sharing applies to select medical benefit
specialty drugs for members who are enrolled in Commercial FLEX products and
other select plans. The member?s cost-sharing amount is based on the terms of
the member's benefit contract. In accordance with your Provider Agreement, it
is the provider?s responsibility to verify a member's individual benefits and
cost-sharing amounts.
The list has been expanded to include approximately 155 drugs, including
additions for the following drugs:
- Crysvita® (burosumab-twza)
- IlumyaTM (tildrakizumab-asmn)
- TrogarzoTM (ibalizumab-uiyk)
- Eculizumab biosimilar
The comprehensive list of specialty drugs with cost-sharing is now available on
our
website.