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The Harken PPO (Preferred Provider Organization) formulary from Harken Healthcare is currently being reviewed by the Centers for Medicare and Medicaid Services (CMS). The PPO provides prescription coverage to many of the Harken group of insurance providers located in all 50 states. This article provides a brief overview of the PPO as it applies to Iowa Medicaid.

2020 AARP/Mandiant Medicare Supplement (MIP) Formulary (Formulary). The Harken PPO Formulary provides the complete list of approved drugs for Part B eligibility, the drug list that is used to calculate the Medicare Part B deductible, and all other drug coverage that may be provided by Harken. A drug list is a list of approved drugs that are eligible for Part B eligibility. In general, a drug list is comprised of one or more drugs for which Harken or its insurers have received approval. A drug list may include several different drugs; if so, each such drug will be identified on the PPO formulary and will have an individual DME code.

A Drug Equivalency Program (DIP). According to the Harken PPO formulary, Harken offers the PPO’s clients access to a Prescription Drug Equivalency Program (PDEP). A PDP is a program that allows pharmacy-based pharmacies and chain drugstores to purchase the same generic medications and brand name medications through the PPO. There are three drug substitution programs available through Harken:

Pharmacy pharmacies are allowed to provide substitution programs for the same brand name medications listed on HVDP plans. HVDP plans cover prescriptions for preventive care only, not for emergency care. HVDP pharmacy pharmacies are not permitted to provide coverage for any emergency drugs.

Chain Pharmacy pharmacies must meet specific criteria set forth by CMS. Most chains must be licensed and registered with CMS or be members of a pharmacy organization.

All HVDP plans require that pharmacies fill out a PPO application. This application is sent via email and is then reviewed by HVDP representatives before a pharmacy fills the PPO application and sends it back to HVDP. For a complete PPO form, please visit the HVDP website.

In summary, the HVDP formulary lists HVDP drugs, generic medication, pharmacy rebates, and PPO discounts. A complete HVDP formulary can be viewed on the HVDP website.

Part A: The PPO plan includes the PPO coverage and the Part B prescription drug benefit. Part A covers prescription drugs listed in Part B. Part B coverage includes prescription drugs listed in Part A and HVDP coverage. Part C offers supplemental coverage not available through HVDP.

The Part C plan was created to help reduce costs for patients with HVDP by covering a variety of non-HVDP drugs. medications.

Pharmacy discounts offered under this plan are not the same as those provided by HVDP. Pharmacy discounts can be obtained in person at your local pharmacy, over the phone, online, by mail, or by fax.

Part C is only available to pharmacy pharmacies with at least 100 pharmacies in their network. Part B is not available to pharmacies owned or operated by a physician, or chain drugstores. However, Part B is available to both physician-owned and chain drugstores.

linkedin through HVDP is subject to an annual limitation, which is set forth in the policy. The annual limitation is based upon the percentage of pharmacy visits covered by the network.

If you choose to enroll in a pharmacy discount plan through HVDP, please review your policy carefully. Most insurance plans do not cover prescriptions. In addition, prescription drugs are not covered under HVDP plans. You must buy your prescriptions from your own pharmacy.

To enroll in the HVDP pharmacy discount plan, you will need to be a licensed pharmacist in good standing with the National Board of Pharmacy Examiners (NBPE) and to have at least two years experience working in the pharmacy industry. Additionally, you will need to complete a PPO application. and HVDP supplemental application.

Before enrolling in a pharmacy discount plan, you should carefully review the benefits provided by each plan. You can also get more information about the HVDP plan by visiting the HVDP website. By choosing to enroll in this plan, you can save up to $1000 annually on prescriptions.