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Preferred & Preventive Drugs

Preferred Drug Lists

In recent years, drug costs have increased dramatically. At Paramount, we understand that it can be frustrating and difficult to pay for high-priced medications. It’s also frustrating to know that costly medications aren’t always the best ones. Though many factors can influence the cost of drugs, high price doesn’t always mean high quality.

Faced with the challenge of bringing costs down as much as possible for our employers and members while giving our physicians the freedom to prescribe the most appropriate drugs, we have developed the Preferred Drug Lists to help identify clinically superior and cost effective medications.

To do this, preferred drugs are brand name medications that are periodically reviewed and updated by a committee of physicians, pharmacists and other allied health professionals (the Pharmacy and Therapeutics Working Group). This group’s job is to make sure that our preferred drugs are of the highest level of clinical efficacy and cost effectiveness.

In our structure, you still get coverage for non-preferred brand name, multi-source brand name, and specialty medications, but your copay will be higher. The result? A plan that offers low costs without sacrificing choices.

Take a look at our current Preferred Drug Lists:

2016 Commercial Open Formulary Preferred Drug List (effective Jan. 1, 2016)  
2017 Commercial Open Formulary Preferred Drug List (effective Jan. 1, 2017)

2017 Commercial Select Formulary Preferred Drug List (effective Jan. 1, 2017)

2016 ACA/Alliance Drug List (effective Jan. 1, 2016)   
2017 ACA/Alliance Drug List (effective Jan. 1, 2017)

2016 Health Insurance Marketplace Drug List (effective Jan. 1, 2016)  
2017 Health Insurance Marketplace Drug List (effective Jan. 1, 2017)

Paramount Advantage (Medicaid) Preferred Drug List 

Preventive Drug Lists

Additionally, some plans include coverage of preventive drugs that are not subject to deductibles, copays, or both. Please refer to your Summary of Benefits and Coverage (SBC) to determine if these lists apply to your plan, and how these drugs may be covered.

Take a look at our current Preventive Drug Lists:

2017 ACA Mandated Preventive Drug List (effective Oct. 1, 2016)
2016 Value-Added Preventive Drug List for CDH Plans only (effective Jan. 1, 2016)  
2017 Value-Added Preventive Drug List for CDH Plans only (effective Jan. 1, 2017)

 

If you have questions about your prescription benefit, just call Paramount's Member Services Department at 419-887-2525 or 800-462-3589. TTY users can call 419-887-2526 or 800-740-5670 toll-free.