July 1, 2017 Non-Medicare Formulary Change

Cigna may make changes to our drug lists which can affect customers at the pharmacy. We include a list of impacted drugs – by drug class – that will be considered non-covered, non-preferred brand or require approval from Cigna for coverage, as well as the covered alternatives.

We send letters to our customers who are impacted explaining the changes to their current medications. However, if a customer with Cigna pharmacy benefits does attempt to refill a medication that is not covered, when appropriate, they can be assisted in the following ways:

• Mention the alternative covered drugs available in the chart below
• Urge the customer to meet with the prescriber to discuss these alternatives or please call the prescriber to facilitate the new prescription
• Help the customer fill out this simple form below to bring to their prescriber [PDF]

Drug Coverage Changes by Class

Please note that this list only applies to our non-Medicare Standard Prescription Drug List and does not reflect the entire list of covered and not-covered drugs for this or any other Cigna drug list.

* Drug is not covered unless approved through a medical necessity review. Customers should speak with their provider about switching to a covered alternative drug.
^ In Step Therapy, customers must try the most cost-effective, appropriate drugs available before their plan approves more expensive brand name drugs.

Pharmacy Forms

Submit a Maximum Allowable Cost (MAC) review form [PDF] for Cigna Preferred pharmacies to request a higher amount of pharmacy coverage for a patient.

Submit an Optum Maximum Allowable Cost (MAC) review form for Cigna Non-Preferred pharmacies to request a higher amount of pharmacy coverage for a patient.

View all Pharmacy forms at CignaforHCP