New customers in Cigna-HealthSpring’s STAR+PLUS plan may already be taking drugs that are not on Texas Medicaid’s preferred drug list or that are subject to certain restrictions, such as prior authorization. Customers should talk to their doctors to decide if they should switch to a different drug without restrictions or request an exception in order to get coverage for the drug.
In order to accommodate this transition for new customers, Cigna-HealthSpring will allow temporary coverage of the drug within the first 90 days of membership in the STAR+PLUS plan. After this temporary supply is covered, Cigna-HealthSpring will not cover the drug again until an authorization request is made.
The only exception to this transition policy are drugs that are not currently listed on the Texas Medicaid comprehensive formulary, which are not eligible for coverage under any circumstance.
FOR MORE INFORMATION
For more detailed information about your Cigna-HealthSpring prescription drug coverage, customers may review their member handbook and other plan materials. Customers may also call Cigna-HealthSpring’s Pharmacy department at 1-888-671-7379 with any questions related to drug coverage, Monday to Friday, 8 AM to 5 PM Central Time, excluding state approved holidays.