[

Beginning in December, some of your AmeriHealth patients may receive a letter from FutureScripts^®, our pharmacy benefits manager, explaining updated guidelines for contraceptive coverage. The letter explains that beginning January 1, 2016, upon group renewal, brand-name contraceptives that have a generic alternative will be covered with standard cost-sharing. The affected drugs are:

• Beyaz^®
• Depo-subQ provera 104^TM
• Ella^®
• Lo Loestrin^®
• Minastrin^®
• Ortho Tri-Cyclen^® Lo
• Safyral^®

Those brand-name contraceptives without a generic alternative or generic equivalent will continue to be covered at 100 percent. Likewise, generic contraceptives will continue to be covered at 100 percent. Brand-name contraceptives with generic equivalents will continue to be covered at standard cost-sharing.

Members are advised to contact their provider to find out if a generic alternative, generic equivalent, or any contraceptive drug that does not have cost-sharing is appropriate for them. When applicable, please issue a new prescription for the member.

For questions about pharmacy coverage, members can call the Pharmacy Benefit telephone number on the back of their ID card.

]