Copayment/Coinsurance Waiver Medication List
List of medications eligible for copayment/coinsurance waiver for State Health Benefit Plan members who enroll and actively participate in specified Case Management or Disease Management programs; affects Anthem and UnitedHealthcare members in the listed state(s).
No material clinical or coverage changes in this revision.
Medications Eligible for Copayment/Coinsurance Waiver
Waiver eligibility and list contents
Medications listed below are eligible for copayment/coinsurance waiver (no cost) for State Health Benefit Plan members who enroll and actively participate in the Case Management Program (Anthem) or Disease Management programs (UnitedHealthcare). Some diabetes products marked with (PA) require prior authorization as noted.
ALL of the following
- Member is enrolled in and actively participating in the Case Management Program (Anthem) or Disease Management programs (UnitedHealthcare).
Contact Anthem Member Services at 855-641-4862 or UnitedHealthcare Member Services at 888-364-6352 for program participation requirements.
ALL of the following
- Asthma medications (eligible for waiver): BREO ELLIPTA; BUDESONIDE NEBULIZER SUSP; FLUTICASONE SALMETEROL; IPRATROPIUM BROMIDE; IPRATROPIUM/ALBUTEROL; PULMICORT FLEXHALER; SPIRIVA HANDIHALER; SPIRIVA RESPIMAT; TRELEGY ELLIPTA; WIXELA INHUB.
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