Regarding: CIGNA RX PRESCRIPTION ERROR
CIGNA has notified us that they are experiencing a global claims processing error and that covered members of California Boiler may experience higher copayments when filling their prescriptions.
The CIGNA claims system does not recognize that a member may have met their Brand Name deductible of $250, for 2015, and/or is requiring that the deductible be applied to GENERIC MEDICATION. This is an error. The correct benefits are as follows:
Tier 1: $15 copayment, No Deductible (most generic medication is classified as Tier 1)
Tier 2: $40 copayment, after the $250 Individual Deductible/$500 maximum per family
Tier 3: $70 copayment, after the $250 Individual Deductible/$500 maximum per family
CIGNA is working on correcting this error; however, they anticipate that a full system correction may not be in place until September 14th. …show more content…
An “override” is the term used to trigger the claim’s system, to allow a prescription to be filled without requiring the full deductible or a portion of the deductible, to be paid at the time that the prescription is being filled.
The below steps will allow you to obtain an override prior to your visit to the pharmacy, and are temporary. Once the system error has been corrected, members will not need to take the proactive steps for an override.
Employees of California Boiler can request a pharmacy override in one of two