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New Medicare Prescription Drug Formulary

New Medicare Advantage Prescription Drug Formulary

In 2019, Kaiser Permanente Washington is adopting the national Kaiser Permanente Part D formulary.  With this formulary change, some drugs are changing tiers. Most affected members will have their tier 1 medications (preferred generic) switched to tier 2 (generic). We’ve lowered copays on tier 2 drugs to help reduce this impact. We’re also adding a mail-order incentive, making a 3-month supply available for just 2 copays.

For most members, the impact of their prescription drugs moving from tier 1 to tier 2 should be minimal. For approximately 3,000 Medicare members, this change will result in an increase in their cost share. The Kaiser Permanente Washington Pharmacy and Member Services teams will be conducting targeted outreach to these members this fall to explain the change and, in coordination with the members’ physicians, review their current medications to see if there is a less expensive medication they can switch to.

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