Virginia Premier continues to be committed to the safety of you, our providers, patients and communities that we serve together. We want to support your heroic efforts to address the COVID-19 outbreak.
Since COVID-19 developments are occurring quickly, we’re providing this update on pharmacy:
Pharmacy Benefit Changes in response to COVID-19:
In response to the COVID-19, Virginia Premier is temporarily changing its pharmacy benefits as follows:Medicaid (CCC Plus and Medallion 4.0)
- All co-pays for FAMIS members are waived. Prescriptions cost $0
- Most prescriptions can be filled for up to a 90-Day supply. Members need to obtain a prescription from their doctor to fill more than a 30-Day supply*. * Note: Narcotics will not be filled for more than a 30-Day supply. A complete list of Schedule II drugs can be found at https://law.lis.virginia.gov/vacode/title54.1/chapter34/section54.1-3448/ .
- Drugs dispensed for 90 days will be subject to a 75% refill “too-soon” edit. Patients will only be able to get a subsequent 90- day supply of drugs after 75% of the prescription has been used (approximately day 68).
- Federal and State law prohibit the early refilling of Schedule II drugs, except in the case of an emergency. Prescribers must continue to comply with all state and federal laws and regulations related to prescribing of controlled substances.
- Members who need to be quarantined should use any network mail order pharmacy. We have an option listed below.
Medicare Advantage Health Plans and Individual and Family Health Plans:
- Most medications may be refilled early for COVID related circumstances.
- Members may use any out-of- network pharmacy but Envision has a national network. We will reimburse members through our member reimbursement mail process. Visit our website at https://www.virginiapremier.com/wp-content/uploads/MemberReimbursementForm.pdf
- Members who need to be quarantined should use any network mail order pharmacy. We have an option listed below.
Network Mail Order Pharmacies:
Network Mail Order Pharmacies:- Curant Health:
- Referrals can be made by a Case Manager
- Call 855-861-2741
- Visit website at curanthealth.com/enrollnow
Pharmacy Authorizations:
- Pharmacy authorizations that were expiring between March 30th and August 3rd have been extended for another 90 days. For example, if an authorization for Lidoderm was expiring 3/30/2020 the new expiration date is 8/3/2020. This will not apply to Hepatitis C drugs or acute illness drugs. For questions regarding authorizations please contact the Pharmacy Technical Call Center at the numbers below.
- Medallion 4: 855-872-0005
- CCC Plus: 844-838-0711
- Medicare Advantage: 855-408-0010
- Individual Plans: 833-626-1350
