preventive drug list

Preventive Drug List -- Promoting wellness, reducing costs

A high-deductible health plan with an HSA does more than just promote smarter spending on health care services and prescription drugs. It actually emphasizes and encourages good preventive care to help maintain an individual’s overall health – now and in the future.

With the Preventive Drug List from BlueCross BlueShield of Tennessee, you can give your employees an added way to stretch their pre-tax health care dollars and focus on improving their personal health.

Advantages of the Preventive Drug List

Guidelines for high-deductible health plans stipulate that preventive care, including prescription medications used for preventive purposes, can be excluded from the deductible. With the Preventive Drug List option, you can choose to have your employees purchase these drugs with a low copay amount – meaning first-dollar coverage for these important drugs.

Using the Preventive Drug List:

• Helps employees stretch their pre-tax funds
• Encourages employees to fill and take preventive drugs as prescribed
• Promotes medication compliance, reducing the risk of future medical needs
• Improves employee adoption and satisfaction with their HSA plan
• Smoothes the transition from a traditional benefit plan to an HSA plan

How medications are processed and paid

The Preventive Drug List includes prescription drugs approved by the FDA to help prevent certain medical conditions as defined by the IRS. If a plan benefit is attached to the Preventive Drug List, any drug on the list will be processed at the appropriate copay, as if the deductible had been met:

• $5 for generic drugs
• $25 for preferred brand drugs
• $50 for non-preferred brand drugs

All other drugs covered under the plan benefit will be subject to the deductible until it is met. Once the annual out-of-pocket has been met, all prescription drugs, including the preventive drugs, are covered at 100%.

Drugs on the list were evaluated and selected based on IRS guidance and clinical validation to ensure that the indications for which they are commonly prescribed are considered preventive within established guidelines. Cost or formulary status was not a factor in the evaluation and approval process.