Please help me with this
I do apologize that medication Bystolic is not listed on your plan's Drug Formulary List and therefore it is a non-covered drug. You can still obtain this medication, but at the full drug cost.
Humana's Pharmacy and Therapeutic Committee determines which drugs are included in the Formulary and which tier the drug is placed on. The Pharmacy and Therapeutic Committee is comprised of licensed clinical pharmacists and medical physicians. Considerations are given to drugs' side effects, drug interactions, cost, and effectiveness and physician preference when making Formulary decisions.
With that said, according to the Humana online Drug Pricing Tool, there are 2 covered alternative drugs listed for Bystolic; Atenolol and Metoprolol Tartrate. Please discuss these possible alternative medications with your physician.
If Bystolic is still the preferred drug, your physician may request a drug exception by initiating a prior authorization request. To request the prior authorization the prescribing physician may contact the Humana Clinical Pharmacy Review Department by phone at 1-800-555-2546. The review will be completed in approximately five days upon receipt of all necessary information from the physician.
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