As a reminder, Harvard Pilgrim offers the opportunity to receive 90-day supplies of maintenance medications for commercial members, and 90-day supplies of both maintenance and non-maintenance medications for our StrideSM (HMO) Medicare Advantage members at retail pharmacies. We encourage providers to prescribe their patients 90-day supplies of maintenance medications in an effort to increase medication adherence.
90-day supplies available at retail pharmacies
Your patients with prescription drug coverage are able to purchase 90-day supplies of maintenance medications at retail pharmacies that participate in MedImpact’s choice90RX program. Members can use our online pharmacy locator to find participating pharmacies. (Providers can view this at www.harvardpilgrim.org/providers by selecting the “Pharmacy” link on the left side of the page, and then the appropriate prescription drug program and “Find a retail pharmacy.”)
Members will pay their typical cost sharing (three times their cost sharing for a three-month supply) at retail locations. Discounts still apply for lower-tier drugs ordered through the Walgreen’s mail service program, which is another option for members who choose to receive 90-day supplies of maintenance medications.
Mail service for maintenance medications only
While the mail service program may be used for 90-day supplies of maintenance medications, it cannot be used for other medications or smaller supplies for members of Harvard Pilgrim’s commercial plans. Non-maintenance medications may be purchased in 30-day increments at retail locations only. This restriction on non-maintenance medications applies only to commercial members; members of Harvard Pilgrim’s StrideSM (HMO) Medicare Advantage plans may receive 90-day supplies of maintenance and non-maintenance medications.
Maintenance vs. non-maintenance medications
Maintenance medications are generally prescribed for the long-term treatment of chronic conditions, and are taken continuously, not intermittently or as needed. Maintenance medications include but are not limited to:
- Asthma/COPD medications
- Cholesterol lowering drugs
- Diabetes medications
- Estrogen therapies
- Heart medications
- High blood pressure medications
- Oral contraceptives
- Seizure medications
- Thyroid medications
Conversely, non-maintenance medications are typically used for treatment of acute conditions. Examples of non-maintenance medications include antibiotics, erectile dysfunction drugs, and controlled substances.