Effective January 1, 2017, AmeriHealth Pennsylvania will update 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. Individual benefits should be verified.
The updated list will include approximately 130 drugs, including new
additions for Cinqair® (reslizumab), Inflectra™
(infliximab)*, Nucala® (mepolizumab), and
Probuphine® (buprenorphine).
The updated list is available on our website. The
current 2016 cost-sharing list can be accessed through this link until December
31, 2016.
Look for more information on medical benefit specialty drug cost-sharing in
the December 2016 edition of Partners in Health UpdateSM.
* For members enrolled in Commercial FLEX products,
cost-sharing applies to all biosimilars to infliximab approved by the U.S. Food
and Drug Administration.