Empire Blue Cross Rx Changes 11/1 – Update

I just completed the webinar with Empire on this.  THESE ARE EXTENSIVE and dramatic changes, so please read carefully.  Here are the main takeaways:

*-  ALL normal Blue Cross plans will be affected and have a change to their drug plan when they renew, starting on November 1.

*- You will NOT be allowed to keep your current plan.

*-   Your Rx premiums will decrease

*-  Third tier drugs will not have a copay.  They will be paid after a deductible and coinsurance.  Remember that these are the most expensive drugs.  If you are on the most popular plan ($10-$35-$70) you will 35% coinsurance on the most expensive drugs.  Empire states the following facts:

     –  97 of the top 100 drugs are Tier 1 and 2 and would not be affected.

     –  90% of all prescritpions are on Tiers 1 and 2 and would not be affected.

     –  22 of the top 25 tier 3 drugs will have a cost less than the current $70 copay, and an average of $4 per Rx.  However, their is a $350 maximum per Rx per month on this plan.

     –  Specialty drugs are taken by 1% of the population, but account for 25% of all Rx Cost, with costs running between $5k-$300k per year.  The most an employee would pay a maximum of $350 (plus the annual deductible) per month for these drugs.