Important Administrative Information (IAI) is a quarterly mailing that delivers the latest news about Blue Cross Blue Shield of Massachusetts products and services to employers and consultants.
Current Editions:
Medications That Now Require Prior Authorization, Effective April 1, 2020
Effective April 1, 2020, until further notice, the following medications will have quantity limits for first-time prescriptions for new therapies. Learn more.
Upcoming 4th-Quarter Changes to the Blue Cross Blue Shield of Massachusetts Formulary
In the fourth quarter of 2020, we're updating our formulary (list of covered medications) for medical plans with pharmacy benefits, as well as Medex®´ plans with a three-tier pharmacy benefit. This update includes changes that were originally scheduled to go into effect on May 1 and July 1. Learn more.
Coverage Update for Truvada
On July 1, 2020, we’ll begin covering Truvada, an HIV pre-exposure prophylaxis (PrEP) medication, at no additional cost for members who aren’t currently filling other HIV medications. This change applies to new prescriptions and refills, and to plans with either the Blue Cross Blue Shield of Massachusetts Formulary or National Preferred Formulary. Learn more.
Coverage Change for Breast Cancer Risk-Reduction Medications
On October 1, 2020, we’ll begin covering the following generic oral medications in the class of aromatase inhibitors at no additional cost for members when the medications are prescribed to reduce breast cancer risk. Learn more.
How to Help Transition Eligible Employees to a Medicare Plan
If you have employees who are ready to retire early, on-time, or after age 65, we have resources that you can use to help them find a Medicare plan that fits their needs. Customize your own Medicare handout with your company logo and details about our Medicare options, and refer them to resources like a Medicare seminar, free Medicare Guidebook, or have them talk to one of our Medicare experts. Learn more.
Important Surveys for Employers: Medical Loss Ratio and Employer Group Size
In July, some accounts will receive at least one survey in the mail from us, which requires a timely response. We send these surveys annually to help determine the size of each of our accounts so we can calculate our Medical Loss Ratio (MLR), establish which accounts are eligible for a rebate to be issued in 2021, and ensure that our members’ claims are properly processed. Learn more.
Important Administrative Information (IAI) is a quarterly mailing that delivers the latest news about Blue Cross Blue Shield of Massachusetts products and services to employers and consultants.