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Upcoming changes to medical benefit specialty drug cost-sharing for 2017

October 3, 2016

Effective January 1, 2017, Independence 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), InflectraTM (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 of infliximab approved by the U.S. Food and Drug Administration.


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