Medicare Advantage

Currently Wegovy is not on the formulary. For members seeking coverage to reduce the risk of cardiovascular events, providers have an option to request a formulary exception.

Premera removed 130 prior authorization codes effective May 1, 2024.

Two new provider license types are now authorized for Medicare plans.

Wegovy is now approved for reducing the risk of cardiovascular death, heart attack, and stroke in overweight adults with cardiovascular disease.

Two important calculation changes for measurement of statin use in persons with diabetes.

An introduction to the Centers for Medicare & Medicaid Services star ratings program.

The new year brings new and existing Medicare Advantage members to your medical practice for their Annual Wellness Visits.

Patients may be excluded from select HEDIS star quality measures due to advanced illness and frailty.

The policies and code list are now updated.

You can now review new changes posted to the Premera Medicare Advantage website.

Medicare Advantage (MA) plans must provide a minimum 90-day transition period for enrollees in active treatment who are switching MA plans.

Introducing two new pharmacy vendors to help members manage the cost of their prescription medications.

A provider recognition program for Medicare Advantage members.

These visits can lead to disease prevention and detection.

The Medicare Advantage policies and code list have been updated.