The 2023 formulary for Harvard Pilgrim Health Care Stride (HMO) plans includes a change to the number of tiers. The 2022 formulary had 5 tiers and the 2023 formulary will have 6 tiers. As a result, some drugs may be on a different tier in 2023. It is important that Brokers review the pharmacy benefit and look up each medication to identify any changes. Remember, Tiers 3,4, and 5 have a deductible.
The Harvard Pilgrim Health Care Stride Pharmacy Team will be doing an analysis to identify changes with current members. Some members may be impacted positively. If there is a negative tier change, a letter will be sent to the member to tell them how the tier and cost of the medication will change beginning 1/1/2023.
We want to make sure all Stride members are aware of these changes to make an informed decision during AEP. We don’t want members to be surprised in January when they pick up their medications at the pharmacy.
If you have any questions about these changes, please contact Medicare Broker support:
Email: medicarebrokersupport@point32health.org
Call: 1-833-984-2387