Aetna 2012 Drug List and More

Each year insurance carriers may change their drug formularies and preferred drug lists for tiered plans.  The link below is the 2012 Aetna drug list to help maximize your benefits for the 2012 calendar year.  There is also a FAQ for answers about generic vs. name brand and about preferred drugs.  If you have any further questions, you can always contact the Customer Care Team at (937) 260-4300 or toll free at (877) 635-5372.

2012 Aetna Drug List and More

Meet the Customer Care Team: Ben

We have been introducing a member of the Customer Care Team over the past months to help put a face to a name or a voice on the phone.  This week we are introducing: Ben

Ben has been with the company since November of 2007 starting in another role before coming to the Customer Care Team.  Ben has a high level of expertise in all areas of customer service.  He truly possesses a unique sense of humor which makes his influence with the team very positive.  Ben resides in West Carrollton, OH.  He enjoys spending time with his fiance.  He has a real passion and talent for music, singing, and playing the guitar.  He is also an avid runner.  We are thrilled to have Ben, who is such an asset to the team.
Say Hello to Ben!

2012 Anthem Formulary

Anthem has a formulary list of preferred drugs for tiered drug plans.  Attached below is the most current drug list. In order to maximize your benefits, the formulary drug list shows you the drugs and tiers of each.  The  associated cost of the tiers could be different depending on what plan you are enrolled in.  Additional information can be viewed online at www.anthem.com under member services or by contacting Anthem at the member number located on the back of your current ID card.  You can always contact the Customer Care team for additional assistance as well at (937) 260-4300 or toll-free (877) 635-5372.

2012 Anthem Drug Formulary

You HAVE The Right To Appeal!

It’s easy to write an appeal…

The option to appeal is a right you have when you disagree how services (claims/prescriptions/benefits) are processed with the carrier.  When you begin to write the appeal there are certain pieces of information you should include to enable the appeal to be reviewed.   

1.    Always have the word "appeal" somewhere in the letter.

2.    Make sure you include the policyholder's insurance information (member ID or social security number, date of birth).  You will also need to include the patient name and date of birth.  See example below:

Policy Holder- John Smith
ID# xxx-xx-xxxx
DOB xx/xx/xxxx
Patient Judy Smith
DOB- xx/xx/xxxx

3.    Make sure to include all dates of service you are appealing in the letter.

4.    Include the reason you are appealing.  (Tell your story/situation)

5.    Include any supporting documentation from your doctor or health professional.

An appeal can take up to 30 days. The explanation of benefits (EOB) gives the information where to send the appeal to. Remember to keep copies of what you send for reference or if you would want to appeal on a higher level with the carrier. Carriers notify in writing directly to the member when the appeal is received and also when the resolution on appeal has been rendered.

The Customer Care Team is available to help with questions on the appeal process.  Please feel free to contact us  Direct  (937-) 260-4300 or toll-free  877-635-5372

2012 UHC Formulary Release!

Below is the 2012 United Healthcare Drug lists for Traditional and Advantage Coverage.  Please review for answers to questions on drug coverage and a whole lot more. If you have any questions please refer to the number on the back of your Identification Card or you can access the United Healthcare website : www.myuhc.com

UHC 2012 Advantage Plan Formulary List

UHC 2012 Traditional Plan Formulary List

Anthem Ends Brand Name Lipitor Drug Coverage

Beginning April 1, 2012, brand name Lipitor will no longer be covered by Anthem Blue Cross and Blue Shield's prescription drug benefit plans. The generic for Lipitor, atorvastatin, will continue to be covered.

Late last year atorvastatin, a new generic for the brand name Lipitor, was added to Anthem's drug list. Atorvastatin is covered by the prescription drug benefit plans. This change means members can save money on their prescription drug costs without giving up quality.

As of mid-January, 84% of members have successfully switched from Lipitor to atorvastatin. Anthem's goal is to encourage all members currently taking Lipitor to switch to atorvastatin to save money on their prescription drug costs without giving up quality.

MEDS FOR little BUCKS!

Here is a website where you can research the popular $4.00 list for medications. It's a really great site to find out if your prescriptions are on $4 list and at what stores. Happy savings!

medtipster.com