Pharmacy Resource Guide – Section 2

     Important changes for 2024

Following are changes to your pharmacy benefits for specialty and maintenance medications.

FOR EMPLOYEES AT OLATHE HEALTH LOCATIONS
Maintenance medication changes effective June 1, 2024, for employees at Olathe Health locations:

Beginning June 1, maintenance medications filled outside the health system pharmacy will not be covered. The sooner you transition your prescriptions, the sooner you can take advantage of lower copays and coinsurance provided by the health system pharmacy.

What you need to do: 

  • Ask your prescriber to send a new electronic prescription to The University of Kansas Health System Southlake Retail Pharmacy.  
  • We recommend sending prescriptions for at least a 90-day supply, which will be a requirement starting June 1. 
  • Do this at least 4 weeks prior to running out of the medication. This allows time for the pharmacy to gather additional information and/or authorization that may be needed. 
  • To save time, contact the pharmacy after the prescription has been sent at 913-574-0600 to ensure they have your preferred delivery address and payment information (for your copay or coinsurance). Delivery is free through the health system’s Southlake Retail Pharmacy.

Formulary review needed before March 15, 2024, for employees at Olathe Health locations

If you’re continuing to use acute or maintenance medications in the new benefits year, you need to check the formulary (the list of covered medications) to see if your medication requires your prescriber to send additional information to Navitus, the health system’s pharmacy benefit manager (PBM).

  • This step is needed, even if your medication was approved by your previous plan, to ensure it is covered under the health system’s plan.
  • To know if your medication(s) requires action, look at the “special code” column on the formulary. If it says:
  • PA: it requires a prior authorization.
  • ST: it requires step therapy (prescribed after trying a less costly, clinically equivalent medication first).
  • RDX: it may only be prescribed for a specific medical diagnosis.
  • Here is a guide with more helpful hints on how to read the formulary.
  • If the formulary says PA, ST or RDX, ask your prescriber to send information to Navitus by March 15, 2024. If you do not take this step, your medication will not be covered.
  • If the “special code” column next to your medication is blank, this step is not needed. If you’re using a maintenance medication, review the information above for another important deadline.   

FOR ALL EMPLOYEES
Specialty medication changes effective January 1, 2024:

Which specialty pharmacy you use will depend on who prescribes your specialty medication:

  • If the prescription is written by a provider at The University of Kansas Health System (excluding Olathe Health), the employee/dependent must use the health system pharmacy
  • If the prescription is written by a provider at Olathe Health or outside the health system, the employee/dependent must use the Navitus preferred specialty pharmacy. Find a Navitus preferred specialty pharmacy through the Navitus member website or mobile app. 

Maintenance medication changes effective June 1, 2024:

  • All maintenance medications must be filled for at least a 90-day supply. To prepare for this change, when your provider writes new prescriptions for your maintenance medications, ask for a three-month supply.
  • Maintenance medications must be delivered from the health system pharmacy to your preferred address (not a work address). You may have your prescriptions sent to your home, another preferred address or a FedEx hold-at/pickup location at no additional cost. Get more information about the pharmacy’s free delivery service.