AmeriHealth has introduced new medical and pharmacy product portfolios that will be available to large group (51+) commercial fully insured and self-funded customers for 2018. The new portfolio options will be offered to new and renewing customers in Pennsylvania beginning with January 1, 2018, effective dates.

The new portfolios feature modern plan designs that were strategically developed to better manage health care costs. Plans in the portfolios include innovative product concepts and cost-management programs, such as site-of-service benefit differentials and a restricted drug formulary called Value Formulary.

Below are additional details on these new plans and plan design features:

• Site-of-service benefit differentials. New site-of-service plan designs allow members to save — in some cases hundreds of dollars — based on where they receive care. Services that members can save on include preventive colonoscopy and outpatient surgery.
• New Value Formulary. All new plans will use the Value Formulary, a new comprehensive list of generic, brand, and specialty drugs. Drugs are included on the Value Formulary based on medical effectiveness, positive results, and value. Because the Value Formulary is restricted, some drugs may not be covered when there are alternative medications used to treat the same condition in a more cost-effective manner. More information about the new Value Formulary will be available on our website in the coming weeks.

Member engagement

To ensure our members have the best experience possible when seeking care, we will contact AmeriHealth Pennsylvania members who are enrolled in new site-of-service plans or one of the new Value Formulary prescription drug plans to help them make appropriate network choices for their care.

We will publish more detailed information in future Partners in Health Update^SM articles to help you navigate these new plans when members present to your provider office for care.