- For the people who will continue to be covered by TennCare, more changes are coming. TennCare will phase in its new prescription drug restrictions by the end of the week.
The State says it will only be able to afford a certain number of prescriptions for each enrollee.
Joseph Phillips is one of the people TennCare will still cover, but the 47 year-old's kidney problems are expensive, especially when it comes to the long list of prescription drugs he's on.
All remaining enrollees on TennCare, except children and institutionalized adults, will have big changes to their coverage. Beginning August 1st, next Monday, there will be new restrictions on how many prescription drugs TennCare will pay for.
Right now, TennCare covers an unlimited number of prescription drugs in any given month. So, if you have eight prescriptions, when the healthcare benefit changes go into effect, TennCare will only cover five of those prescriptions.
Of the five prescription drugs filled each month, only two can be brand name drugs. The other three have to be generic. The new co-pay for brand name drugs will be $3.00.
If you are on a certain drug regimen, for something like cancer, each medication on your treatment won't necessarily count towards your five prescriptions per month limit.
Some of your medicines will cost more than others. TennCare advises you to go over some of the pricing with your doctor and make sure he or she prescribes the most expensive ones first, because TennCare is only going to cover the first five prescriptions.
For those who've lost their TennCare coverage and are not being picked up under Medicaid, there's a number you can call.
The Health Options hotline based out of Memphis is taking about 400 calls a day.
The hotline is connecting people with low cost services in their county. You can also get more information on prescription - assistance programs.
The Health Options hotline number is 1-888-486-9355.
Tuesday, July 26, 2005
TennCare To Phase In New Prescription Restrictions Soon