Commercial changes and effective dates
Upcoming pharmacy policies effective February 1, 2025
Upcoming pharmacy policies effective January 1, 2025
Upcoming pharmacy policies effective December 1, 2024
Upcoming pharmacy policies effective November 1, 2024
Upcoming pharmacy policies effective October 1, 2024
Upcoming pharmacy policies effective September 1, 2024
Upcoming pharmacy policies effective August 15, 2024
Upcoming pharmacy policies effective August 1, 2024
Upcoming pharmacy policies effective July 15, 2024
Upcoming pharmacy policies effective July 1, 2024
Upcoming pharmacy policies effective June 1, 2024
Upcoming pharmacy policies effective May 1, 2024
Upcoming pharmacy policies effective April 1, 2024
Upcoming pharmacy policies effective March 1, 2024
Upcoming pharmacy policies effective February 1, 2024
Prior authorization for a pharmacy benefit drug
To submit a prior authorization request for a pharmacy benefit drug, providers can visit CoverMyMeds
Medicaid changes and effective dates
Upcoming pharmacy policies effective January 1, 2025
Upcoming pharmacy policies effective December 1, 2024
Upcoming pharmacy policies effective November 1, 2024
Upcoming pharmacy policies effective September 1, 2024
Upcoming pharmacy policies effective August 1, 2024
Upcoming pharmacy policies effective July 1, 2024
Upcoming pharmacy policies effective June 1, 2024
Upcoming pharmacy policies effective May 1, 2024
Upcoming pharmacy policies effective April 12, 2024
Upcoming pharmacy policies effective April 9, 2024
Upcoming pharmacy policies effective April 1, 2024
Upcoming pharmacy policies effective March 15, 2024
Upcoming pharmacy policies effective March 1, 2024
Upcoming pharmacy policies effective February 1, 2024
Upcoming pharmacy policies effective January 1, 2024
Upcoming pharmacy policies effective December 1, 2023
Note: Not all employer groups retain Prime Therapeutics as their pharmacy benefits manager (PBM). The pharmacy policies content only applies to those employer groups who retain Prime Therapeutics. Member ID cards with RxBIN 610455 and RxPCN PGIGN or HMHS on the front indicate that a member has Prime Therapeutics as their PBM and these pharmacy policies apply.