Effective January 1, 2018, AmeriHealth Pennsylvania updated its list
of specialty drugs that require member cost-sharing (e.g., 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 150 drugs, including
additions for the following drugs:
- FasenraTM (benralizumab)
- LuxturnaTM (voretigene neparvovec-rzyl)
- MepseviiTM (vestronidase alfa-vjbk)
- Radicava® (edaravone)
- SublocadeTM (buprenorphine)
The comprehensive list of specialty drugs with cost-sharing is now available on
our
website.