Back to Insights and Updates for ProvidersMarch 2025

Pharmacy coverage changes

Harvard Pilgrim Health Care Commercial  |  Tufts Health Direct  |  Tufts Health Plan Commercial  |  Tufts Health RITogether  |  Tufts Health Together

Updates to existing prior authorization programs
Drug Plan Eff. date Policy & additional information
Non-Formulary Exceptions Harvard Pilgrim Commercial, Tufts Health Plan Commercial, Tufts Health Direct 5/1/2025 Non-Formulary Exceptions

For formularies subject to non-formulary review, added coverage criteria for Zepbound’s supplemental indication for moderate to severe obstructive sleep apnea in obesity.