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Here is some good news about a change to Welfare Fund and Emblem Health drug coverage.
Effective July 1st, 2020, the GHI-CBP and HIP HMO plans will cover the cost of health care services and medicines for the detection and prevention of HIV, including screenings and pre-exposure prophylaxis (PrEP). This means there will be no cost-sharing, including copays, coinsurance or deductibles for HIV prophylaxis (PrEP) medications.
As of July 1, PrEP medications will be available, free of charge, when members present their GHI-CBP or HIP HMO card along with a doctor’s prescription at the pharmacy. They will no longer be able to use the Welfare Fund CVS Caremark card for PrEP medications.
We understand that the switch in coverage for these prescriptions may be cause for confusion, at first, but we believe the savings members will experience will outweigh any initial inconvenience.
IMPORTANT NOTE
If members are unable to derive results from Truvada, their provider can request Descovy on an exception-basis only. Providers will need to call 1-833-269-4653 for HIP members and 877-534-3682 for GHI members.If members have been denied, they can appeal using one of the following methods:By Phone:1-877-793-6253In writing by mail:EmblemHealthGrievance and Appeals UnitPO Box 2844New York, NY 10116-2844By fax:EmblemHealthGrievance and AppealsUnit1-212-510-5320
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