March 17, 2020
The following memorandums were released today by DHR and DFR, concerning prescription drug refills. VSEA members are urged to read and take advantage of the new guidelines when refilling your prescriptions.
From: DHR – Commissioner’s Office
Date: March 17, 2020 at 2:49:22 PM EDT
Subject: Employee Pharmacy Benefit and Department of Financial Regulation Bulletin Regarding COVID-19 Prescription Drug Refills
Dear State Employee,
Effective immediately and in compliance with the Department of Financial Regulation Insurance Bulletin #210 (media advisory below), the following State Employee Health Plan design changes have been implemented related to pharmacy benefits and the COVID-19 pandemic.
Plan members are encouraged to use the mail-order service of Express Scripts that allows medications to be delivered directly to members’ homes. This will ensure that members have the medications they need while also minimizing the need for Vermonters to physically visit pharmacies, consistent with the recommended practice of social distancing. This service is available at no additional cost, and the same coinsurance and deductibles apply.
As an alternative, members with ongoing medications can refill their medications earlier than otherwise permitted under the plan to ensure adequate supply. There is a one-time “refill too soon” exception for each medication that can be put in place at the pharmacy at the time of fill.
For more information and assistance in setting up either the mail-order service or to coordinate the “refill too soon” benefit, please contact Express Scripts at (800) 550-0890.
DFR Media Advisory: Insurance Bulletin Regarding COVID-19 Prescription Drug Refills
For Immediate Release: March 10, 2020
Montpelier, VT – On March 16, 2020, the Vermont Department of Financial Regulation issued Insurance Bulletin #210 regarding COVID-19 Prescription Drug Refills.
The purpose of this bulletin is intended to ensure that health insurance plans regulated by the Department of Financial Regulation continue to provide access to prescription drugs during the COVID-19 pandemic. This bulletin applies to health insurers and pharmacy benefit managers (PBM).
• In order to minimize the need for Vermonters to physically visit pharmacies, the department is directing insurers to make at least a 30-day supply of medication available to members refilling their prescriptions.
• The department encourages, but does not require, that insurers make available a larger-than-30-day supply when appropriate.
• Narcotic and specialty medications shall continue to be subject to each insurer’s standard refill policy.
• The department encourages insurers and PBM to work with retail pharmacies to offer home delivery services and to expand use of mail-order pharmacy services.
• Insurers and PBMs are reminded that retail pharmacies must be permitted to fill prescriptions in the same manner and at the same level of reimbursement as mail-order pharmacies.
If patients need assistance picking up prescription medications, please contact your local pharmacy for assistance.