Spotlight on Pharmacy Programs
Members new to Unity may be taking medicines that need a Prior Authorization for coverage. Unity’s formularies will note the drugs that need Prior Authorization. In this case, Unity will authorize coverage for these drugs for up to 90 days (in 30 day increments at the usual copayment). After those 90 days, prior authorization will be required for additional coverage. In the meantime, new members should talk to the doctor who prescribed the medicine. The doctor can check to see if a different drug will work.
Members can request a “New Member Override.” To do this, the member or pharmacy can call Unity Pharmacy Services at 800.788.2949. This should be done within the first 90 days of becoming a Unity member.
Please note: this policy only applies to medications that a member was taking prior to joining Unity. Standard copays based on the member’s drug benefit and formulary status of the medication apply.
Choice90 makes it easier for members to receive a 90-day supply of the medicine they are taking most often. More than 1,000 pharmacies in Wisconsin participate in the program.
*The program is not available for Unity members with drug coverage through Navitus or BadgerCare Plus, or those who do not have a drug benefit. Medications that are excluded from coverage are not eligible for Choice90. Medications that require Prior Authorization must have a valid prior authorization in place before Choice90 will process.
View List of Summer 2016 Unity Update Articles
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Quartz Health Solutions, Inc., Unity Health Plans Insurance Corporation, Gundersen Health Plan, Inc., Gundersen Health Plan Minnesota, Physicians Plus Insurance Corporation, Gundersen Health System, UnityPoint Health and UW Health are separate legal entities. Plans are underwritten by Unity Health Plans Insurance Corporation unless otherwise noted.