Because of some confusion over the new formulary, the state health plan recently sent a letter to patients and providers clarifying the new coverage. Read the letter to providers, and the letter to patients.
As stated in the letter, there is a formulary exclusion exception process available for patients that have a medical necessity to remain on a non-covered drug. The exception process is administered by CVS Caremark®, the Plan’s Pharmacy Benefit Manager. You can request an exception form by calling CVS Caremark Customer Care at 888-321-3124, or find the form on the Plan website at www.shpnc.org by clicking Pharmacy Benefits under Plans for Active Employees.