Prescription Drug Benefit
Coverage under each of the health options (Standard, Advantage P and HealthFund) includes a prescription drug benefit.
Through December 31, 2009, Caremark continues to administer the prescription drug plan. For 2009 prescription costs for each of the three options, click on the links for each option on the Health Care Plan page.
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Navitus Health Solutions to Manage Prescription Drug Benefit
Beginning January 1, 2010, Navitus Health Solutions will manage the Vanderbilt Health Plan's prescription drug benefit.
Implementation Schedule for Navitus Prescription Drug Program
| Welcome Letters Mailed to Vanderbilt Health Plan Participants | November 16 |
| Information Mailed from the Vanderbilt Pharmacy to Participants Taking Specialty Medications | November 19 |
| Member Booklets with ID Cards Mailed | Week of December 21 |
| Vanderbilt Health Plan Participants Begin Using Navitus ID Card for Prescription Drugs | January 1, 2010 |
There are important changes to the formulary (preferred drug list) that may impact you. Navitus and Vanderbilt have prepared a brief list of important changes, including the prices for prescription drugs beginning January 1, 2010.
Click here to log in with your VUnet ID and e-password to access this important information.
Navitus Contact Information
Web site: www.navitus.com
Customer Service: 866.333.2757
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Prescription Drug Benefits
You will get the best cost at one of the Vanderbilt pharmacies (located in The Vanderbilt Clinic, Medical Center East, Vanderbilt Children’s Hospital and Vanderbilt Health One Hundred Oaks).
Not all pharmaceuticals are covered by the Vanderbilt Group Health Care Plan. Some pharmaceuticals not covered inlcude, but are not limited to, Viagra, Cialis and medical-food supplements like infant formula. Some pharmaceuticals that require prior authorization from CAREMARK before the prescription can be filled, include, but are not limited to, Lamisil and all specialty drug medications (see below for more information on specialty drugs). For specific pharmaceutical drug coverage questions, please contact CAREMARK, 866.273.8570 and refer to Plan Code "CRK" and Group Code "VBURX".
Specialty Drugs
Click here for the 2009 CAREMARK speciality drug list (only drugs approved through the prior authorization process will be covered by the Vanderbilt Health Plan). The specialty drugs on this list are not necessarily all covered under the Vanderbilt Group Health Care Plan, rather, this is CAREMARK's list for all of its clients.
Vanderbilt utilizes an evidence-based specialty pharmacy program administered by CAREMARK to consistently manage specialty pharmacy utilization in accordance with current standards of care. This guideline management program requires preauthorization for all specialty drugs before a prescription can be filled.
Coverage of specialty drugs is available only when filled through one of the Vanderbilt pharmacies or the Caremark mail order program. Specialty drugs are typically targeted at specific, very serious diseases; self-administrable injections; biotechnologically produced or genetically engineered; require special storage and handling; and are very expensive.
Caremark Web site
The Caremark Web site contains helpful information and many tools. Become a registered user of their Web site by completing a short online form (you will need your Caremark prescription benefit card). Through their Web site you will be able to refill a prescription, find the current formulary*, access prescription and coverage information, and look up participating pharmacies.
Navitus Contact Information
Web site: www.navitus.com
Customer Service: 866.333.2757
* Formulary is a list of preferred drugs.
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HR Express 2525 West End Ave Suite 218 Nashville TN 37203 Hours M-F 7:30 - 5:30 Last Updated: November 12, 2009 |
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