If You are a New Passport Advantage Member
If you are a new Passport Advantage member and are taking a
drug that is not on our formulary, we will work with you and
your provider to help you change to a covered drug. First, we
will allow you to fill a prescription for a 15-day supply of
the drug you are currently taking. Then, we will contact your
provider and explain that we do not cover that drug. If your
provider agrees that you could switch to a drug on the formulary
without an office visit, your provider will call your pharmacy
with a prescription for the new drug. If your provider thinks
that you need an office visit, your provider will contact you
to schedule a visit within 60 days. We will then allow you to
fill the prescription to last until the visit with your provider.
We will work with your provider to allow you to transition gradually
from a drug that requires tapering off. However, in most instances,
we expect that you will have switched to a drug on the Passport
Advantage formulary within six months of becoming a member.
If You are a Current Passport Advantage Member And We Change
Our Formulary
If we change our formulary and remove a drug you are taking,
we will help you change to a covered drug. Before we change
our formulary, we will contact your provider and explain that
we are changing the formulary. If your provider agrees that
you could use a different drug that is on our formulary, your
provider will give you a new prescription. If your provider
does not agree, your provider may ask for an exception. Read
our Exception and Prior Authorization
Policy for more information.
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