Why aren’t all plans eligible?
Not all member plans are eligible. This does not apply to TRICARE members and our commercial self funded ASO clients. We are working in close partnership with the Defense Health Agency (DHA) to determine how best to support TRICARE beneficiaries.
Self-funded ASO clients bear the financial risk for coverage decisions, and we are not able to make coverage policy changes without their approval. We are reaching out to these clients to confirm whether they will follow our approach. If you are unsure if you fall into this category, you should confirm your employer-sponsored coverage type with your employer.
This does not apply to Part D-only plan members. Part D-only plan members continue to be eligible for prescription benefits.
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