Some prescription diabetes drugs currently covered as preferred will be considered non-preferred beginning Nov. 1, 2016, for non-metallic health plans, or plans not governed by the Affordable Care Act, such as large group plans and grandfathered plans.
The largest change is that LifeWise Oregon has selected Novo Nordisk (Novolin, Novolog, and others) as our preferred manufacturer for insulins. Insulins made by Lilly (Humulin, Humalog, and others) and Sandoz (Apidra) will be non-preferred.
As a result of these changes, non-preferred insulins will require pre-approval before the plan will pay benefits.
We will be sending letters to impacted employees on non-metallic health plans around Aug. 15. In addition, we will send these members a reminder letter one month prior to the effective date, and, if needed, a post-effective date letter.
Letters to members will provide more details and a number to call with questions.