Pharmacy Management Program

Step Therapy - Coming Soon

Quantity Limits - Generally, The Health Plan allows dispensing of approved medications up to a 31-day supply per co-pay at the retail pharmacy network. Quantity per dispensing event rules (QPC) set thresholds that reduce exposure to unnecessary cost, without creating obstacles to access for most members. Drugs that are subject to QPC rules usually have specific limitations for use approved by the FDA. Examples include drugs to treat migraine headaches. These drugs known as "triptans" are to be used in specific doses up to a defined number of headaches per month. The QPC rules allow this specific number of triptan medications to be dispensed per 31-day benefit period. To inquire about QPC limits, have your provider contact Pharmacy Services Department at 1.800.624.6961, ext. 7914.

Drugs That Require Prior Authorization - Coming Soon