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Health Insurance Administration implements new policy for medications during and after Fiona

Through a statement, the entity established a policy to guarantee access to medicines for Vital Plan beneficiaries, without distinction, due to Hurricane Fiona.

This Tuesday ASES issued a statement on medications due to the passage of Hurricane FIONA.

In this, the Pharmacy Benefit Administrator is authorized to make a modification in the refill to soon paragraph and allow the output of a 50% medication repetition, without the need for confirmation from the primary physician.

restrictions

This does not apply to medicines controlled, these must be governed by the dispensation process of the Current Law.

Pharmacies contracted to serve the population of the Government Health Plan, Vital Plan, are not allowed to ask beneficiaries to pay the cost of the medication under Vital’s coverage in cash or another payment method.

These may only charge the beneficiary the copayment established by the Vital Plan insured card. Those that do not comply with this guideline may be removed from the pharmacy network of the Government Health Plan.

This policy will be effective upon its publication and for the duration of the emergency as a result of the Fiona atmospheric event.

What is Vital Plan?

The Vital Health Plan of the Government of Puerto Rico is responsible for providing physical and mental health services to 1.6 million Puerto Ricans. Services are offered by networks of providers (primary physicians, specialists, laboratories, etc.) throughout the Island.

What benefits does it bring?

  • Preferred Network of the Primary Medical Group: With Vital, the Primary Medical Group will have a Preferred Network that includes: specialist doctors, laboratories, X-rays and hospitals, among others.

  • Countersignature: A countersignature from the Primary Physician is not required for Preferred Network specialist prescriptions.

  • Mental Health Coverage: Access to mental health services through a mental health professional in the facilities of the Primary Medical Group.

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