Information Last Updated: 1/25/2021
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The formulary represents the prescription therapies believed to be necessary in a quality treatment programs and was designed by Brand New Day in consultation with a team of healthcare providers.
Prescribed medications are covered by the Plan as long as the drug is medically necessary and all plan rules are followed. Refer to your Evidence of Coverage (EOC) for additional information on Part D Prescription Drug coverage or call Brand New Day Pharmacy Services.
Medication Therapy Management Program
Brand New Day may add or remove drugs from our formulary throughout the year. If we remove a drug from our formulary, add prior authorization for a drug, add quantity limits and/or step therapy restrictions on a drug, or move a drug to a higher cost-sharing tier, we must alert members taking that drug about those changes. If we’re removing a drug from our formulary, we’ll either notify affected members 60 days prior to making that change, or notify them when they request a refill of that drug (at which time the member will also receive a 60-day supply of that drug). If the Food and Drug Administration deems a drug on our formulary to be unsafe, or the drug’s manufacturer removes the drug from the market, we’ll immediately remove the drug from our formulary and provide notice to members taking that drug.
To find your prescription drug within the formulary, search by your Plan & Drug name above.
Contact our Pharmacy Services Department at 1-866-255-4795 or TTY 711 to discuss options. Or ask your doctor if there's an acceptable alternate medication covered under our formulary.
Prescription Drug Transition Policy
Part D Prior Authorizations, Coverage Determinations, and Exceptions
Extra Help to Pay for Prescription Drugs – For more information about the BAE policy, contact Member Services at 1-866-255-4795.