CHIP – Opioid (QLL) drug list update
Effective January 1, 2021
Benefit determination
The existence of this pharmacy policy does not mean that this service is a covered benefit under the member’s contract. Benefit determinations should be based in all cases on the applicable contract language. Pharmacy policies do not constitute a description of benefits. A member’s individual or group customer benefits govern which pharmaceuticals are covered, which are excluded, and which are subject to benefit limits and which require authorization. Members and providers should consult the member’s benefit information or contact us for benefit information.
Key:
UPPERCASE names = Brand
lowercase names = Generic
1Specialty
2Limited Distribution
3Split Fill