As of July 1, 2018, Independence updated its list of
specialty drugs that require member cost-sharing (i.e., copayment, deductible,
and coinsurance). Cost-sharing applies to select medical benefit specialty
drugs for members who are enrolled in Commercial FLEX products and other select
plans. The member's cost-sharing amount is based on the terms of the member's
benefit contract. In accordance with your Provider Agreement, it is the
provider's responsibility to verify a member's individual benefits and
cost-sharing amounts.
The list has been expanded to include 155 drugs, including additions for the
following drugs:
- Crysvita? (burosumab-twza)
- IlumyaTM (tildrakizumab-asmn)
- TrogarzoTM (ibalizumab-uiyk)
- Eculizumab biosimilar
The comprehensive list of specialty drugs with cost-sharing is available on
our website.