We recently received notification from the Philadelphia Federation of
Teachers (PFT) Health and Welfare Fund that they will no longer cover certain
diabetic drugs, including Byetta®, Bydureon®,
Symlin®, SymlinPen®, Tanzeum®,
Trulicity®, and Victoza®, under their
prescription drug coverage effective November 1, 2017. School District of
Philadelphia employees who have their prescription drug coverage through PFT
have Independence HMO and PPO medical coverage.
The PFT erroneously communicated to affected School District of Philadelphia
employees that they can obtain these diabetic drugs by having their physician
submit a Direct Ship Drug Request to Independence. Please be aware that this
information is inaccurate, and diabetic drugs are not available through the Direct Ship
Drug Program.
If your patients who have Independence medical coverage through the School
District of Philadelphia ask you to complete a Direct Ship Drug Request on
their behalf for the diabetic drugs listed above, please inform them that the
School District of Philadelphia has a benefit that allows for reimbursement of
diabetic drugs under their medical coverage. These Independence members will
need to purchase their medication from their pharmacy and submit the Medical
Claim Form for reimbursement. Members can access the Medical Claim
Form by following these steps:
- Log onto our secure member website at www.ibxpress.com.
- Select Resource Center at the top of the screen.
- Check the Form box under Media Types on the left side.
- Select the Medical Claim Form from the Claims category.
As was the case before, the only thing you?ll need to provide your patients who
have Independence medical coverage through the School District of Philadelphia
with is a standard prescription for the drug.
If your affected patients have questions about this process or would like a
paper copy of the claim form, please have them call the Customer Service number
on their member ID card.