Extended Day Supply Prescription
Date: 06/14/24
Extended Day Supply Prescription
MAPD (HMO & PPO), CSNP (HMO), & DSNP (HMO)
Extended-Days prescriptions (90 to 100-day supply) give patients asimple way to adhere to taking their medications.
They also offer added convenience.
Standard 30-day fills of maintenance medications require patients to make a trip to the pharmacy every single month,year after year. However, when you write for an extended-day prescription, patients' pharmacy trips drop from 12annual trips to only three.
Members can fill their Extended-Days prescriptions at any willing network pharmacy, but our members may benefit financially if they use Medication Home-Delivery through Express Scripts.® The tablebelow represents the Medicare Advantage formulary benefit for using Medication Home-Deliverythrough Express Scripts,® which includes $0 co-pays for tier 1 and 2 medications and up to $20 savings every month for select medications in Tier 1 through Tier 3, and Tier 6 with an Extended-Days supply.Tier
Tier | Preferred Home Delivery Cost Benefits |
1 | $0 co-pay |
2 | $0 co-pay |
3 | 2 x 30-day retail co-pay when applicable |
6 | Greater than 98% claims are $0 co-pay |
Express Scripts® is currently our only preferred home-delivery pharmacy. Prescribers can fax or e-prescribe member prescriptions to Express Scripts.® A prescription form and contact information are listed below:
- ExpressScripts RX Form
- Fax: 1-800-837-0959
- E-prescribe to Express Scripts® Mail Order Electronic, NCPDP ID 2623735
Members must create an account with Express Scripts® online or by telephone at: 1-800-282-2881 (TTY: 711)
Adherence Medication Tiering
The tiering structure for the most common maintenance medications under Wellcare Medicare Advantage plans arelisted below. Please note: This list is not all-inclusive
Medicare Advantage Tiering Structure for Adherence Medications
Tier | Blood Pressure | Cholesterol | Oral Diabetes |
---|---|---|---|
Tier 1 Preferred Generic | |||
Tier 2 Generic | |||
Tier 3 Preferred Brand |
| ||
Tier 6§ Select Care |
|
|
|
*Jentadueto, Jentadueto XR, and Tradjenta are structured under Tier 4 for 6-Tiered Enhanced Plus Chronic ConditionSpecial Needs Plans (C-SNPs).
§ Select Care medications are structured under Tier 1 for 6-Tiered Enhanced Plus C-SNPs.