Back to Insights and Updates for ProvidersMay 2024

Pharmacy coverage changes

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

The chart below identifies updates to our Pharmacy program. For additional details, refer to the Pharmacy Medical Necessity Guidelines page on our Point32Health provider website, where you can find the policies that detail coverage criteria for our Harvard Pilgrim and Tufts Health Plan lines of business.

Updates to existing prior authorization programs

Visit the Pharmacy Medical Necessity Guidelines page on our Point32Health provider website for details.

Drug/policy Plan & additional information Eff. date
Synarel

Endocrine Agents

 

Harvard Pilgrim Commercial, Tufts Health Plan Commercial, Tufts Health Direct 7/1/2024
Vtama

Zoryve

Dermatological Immunomodulators

 

Harvard Pilgrim Commercial, Tufts Health Plan Commercial, Tufts Health Direct 7/1/2024
Drug status changes
Drug Plan & additional information Eff. date
GlucaGen HypoKit Harvard Pilgrim Commercial, Tufts Health Plan Commercial, Tufts Health Direct

Glucagen HypoKit will be discontinued on 7/1/2024 and will move to Nonformulary status.

7/1/2024

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