My husband worked for a company that had BCBS of TN. The two plans were Plan S and Plan P, which are common employer plans. That year, we had to pay for whatever option we wanted, and both plans used Optimum RX for pharmacy. This year they offer the same plans, but they offered to pay for anyone chosing Plan S, and they switched from Optimum RX to Veracity RX.
Year one we did Plan P and they paid for my medicines.
This year we went with Plan S since its paid for, but 2 of the 4 medicines im on are no longer covered.
When I go to BCBS of TN and put in Plan S or P, it says they will pay for those medicines on both plans. So im just confused. Is it the pharmacy benefit change to Veracity RX that the problem? If so, im assuming a change back to P wont matter since both plans now use Veracity right?
Posted by Bubbly-llama17
1 Comment
Call them. Formularies (lists of approved and tiered meds) change year to year and plan to plan. Could be related to the switch from Optimum to Veracity, could be related to the underlying plan, could be something else entirely, could be an error on Veracity’s part. Get someone knowledgeable on the phone and you’ll soon find the correct answer. Anyone offering guidance here is almost certainly just guessing.