o EYSUVIS (loteprednol etabonate) Explore differences between MinuteClinic and HealthHUB. Disclaimer of Warranties and Liabilities. NUCALA (mepolizumab) STEGLATRO (ertugliflozin) NEXVIAZYME (avalglucosidase alfa-ngpt) The AMA disclaims responsibility for any consequences or liability attributable or related to any use, nonuse or interpretation of information contained in Aetna Clinical Policy Bulletins (CPBs). VUMERITY (diroximel fumarate) HALAVEN (eribulin) 2 z@vOK.d CP'w7vmY Wx* trailer ADLARITY (donepezil hydrochloride patch) SPRYCEL (dasatinib) TAGRISSO (osimertinib) For language services, please call the number on your member ID card and request an operator. MINOCIN (minocycline tablets) J AMEVIVE (alefacept) The Dental Clinical Policy Bulletins (DCPBs) describe Aetna's current determinations of whether certain services or supplies are medically necessary, based upon a review of available clinical information. How to access the OptumRx PA guidelines: Reference the OptumRx electronic prior authorization ( ePA ) and (fax ) forms. XEMBIFY (immune globulin subcutaneous, human klhw) AJOVY (fremanezumab-vfrm) Members should discuss any Clinical Policy Bulletin (CPB) related to their coverage or condition with their treating provider. XELJANZ/XELJANZ XR (tofacitinib) Tried/Failed criteria may be in place. 0000003227 00000 n A $25 copay card provided by the manufacturer may help ease the cost but only if . MinuteClinic at CVS services VFEND (voriconazole) TREMFYA (guselkumab) But at MinuteClinics located in select CVS HealthHUBs, you can also find other professionals such as licensed therapists who can help you on your path to better health. submitting pharmacy prior authorization requests for all plans managed by SYMTUZA (darunavir, cobicistat, emtricitabine, and tenofovir alafenamide tablet ) In addition, coverage may be mandated by applicable legal requirements of a State or the Federal government. 0000069452 00000 n XADAGO (safinamide) TUKYSA (tucatinib) MYALEPT (metreleptin) * For more information about this side effect . prescription drug benefits may be covered under his/her plan-specific formulary for which MAVENCLAD (cladribine) ), DPL-Footer Legal And Social Bar Component, Utilization management changes, effective 01/01/23, Fraud, waste, abuse and general compliance, Language Assistance / Non-Discrimination Notice, Asistencia de Idiomas / Aviso de no Discriminacin, Food and Drug Administration (FDA) information, Peer-reviewed medical/pharmacy literature, including randomized clinical trials, meta-, Treatment guidelines, practice parameters, policy statements, consensus statements, Pharmaceutical, device, and/or biotech company information, Medical and pharmacy tertiary resources, including those recognized by CMS, Relevant and reputable medical and pharmacy textbooks and or websites, Reference the OptumRx electronic prior authorization. We strongly 0000017382 00000 n GLYXAMBI (empagliflozin-linagliptin) NORTHERA (droxidopa) TRIKAFTA (elexacaftor, tezacaftor, and ivacaftor) BCBSKS _ Commercial _ PS _ Weight Loss Agents Prior Authorization with Quantity Limit _ProgSum_ 1/1/2023 _ . Other times, medical necessity criteria might not be met. <> Pharmacy General Exception Forms 0000003755 00000 n Capsaicin Patch 0000008484 00000 n 0000069682 00000 n See multiple tabs of linked spreadsheet for Select, Premium & UM Changes. SHINGRIX (zoster vaccine recombinant) Weight Loss Medications (phentermine, Adipex-P, Qsymia, Contrave, Saxenda, Wegovy) Antihemophilic Factor VIII, Recombinant (Afstyla) TIBSOVO (ivosidenib) STELARA (ustekinumab) Bevacizumab KERYDIN (tavaborole) But there are circumstances where there's misalignment between what is approved by the payer and what is actually . 3 0 obj Alogliptin (Nesina) NEXLETOL (bempedoic acid) ICLUSIG (ponatinib) TEPMETKO (tepotinib) encourage providers to submit PA requests using the ePA process as described TRODELVY (sacituzumab govitecan-hziy) A 0000008455 00000 n NAPRELAN (naproxen) EYLEA (aflibercept) AUSTEDO (deutetrabenazine) <]/Prev 304793/XRefStm 2153>> Off-label and Administrative Criteria RYBREVANT (amivantamab-vmjw) SILIQ (brodalumab) VIVLODEX (meloxicam) Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. You, your employees and agents are authorized to use CPT only as contained in Aetna Precertification Code Search Tool solely for your own personal use in directly participating in health care programs administered by Aetna, Inc. You acknowledge that AMA holds all copyright, trademark and other rights in CPT. Please note also that the ABA Medical Necessity Guidemay be updated and are, therefore, subject to change. FULYZAQ (crofelemer) NEXAVAR (sorafenib) Treating providers are solely responsible for medical advice and treatment of members. Since Clinical Policy Bulletins (CPBs) can be highly technical and are designed to be used by our professional staff in making clinical determinations in connection with coverage decisions, members should review these Bulletins with their providers so they may fully understand our policies. z For those who choose to cover Wegovy, PSG recommends the following: Thoroughly evaluate the financial impact of covering weight loss drugs; Better outcomes are expected when Wegovy is combined with other weight management strategies. You may also view the prior approval information in the Service Benefit Plan Brochures. TYMLOS (abaloparatide) Antihemophilic factor VIII (Eloctate) Therapeutic indication. Aetna has reached these conclusions based upon a review of currently available clinical information (including clinical outcome studies in the peer-reviewed published medical literature, regulatory status of the technology, evidence-based guidelines of public health and health research agencies, evidence-based guidelines and positions of leading national health professional organizations, views of physicians practicing in relevant clinical areas, and other relevant factors). KERENDIA (finerenone) OPZELURA (ruxolitinib cream) Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CPT for resale and/or license, transferring copies of CPT to any party not bound by this agreement, creating any modified or derivative work of CPT, or making any commercial use of CPT. REVLIMID (lenalidomide) 0 ZEJULA (niraparib) E Step #1: Your health care provider submits a request on your behalf. AMPYRA (dalfampridine) 0000013580 00000 n Health benefits and health insurance plans contain exclusions and limitations. MYFEMBREE (relugolix, estradiol hemihydrate, and norethindrone acetate) Wegovy has not been studied in patients with a history of pancreatitis COVERAGE CRITERIA The requested drug will be covered with prior authorization when the following criteria are met: The patient has completed at least 3 months of therapy with the requested drug at a stable maintenance dose AND WAKIX (pitolisant) RHOFADE (oxymetazoline) u This Agreement will terminate upon notice if you violate its terms. Prior Authorization Criteria Author: PROMACTA (eltrombopag) ACCRUFER (ferric maltol) LIVTENCITY (maribavir) MinuteClinic at CVS is a convenient retail clinic that you'll find in select CVS Pharmacyand Target stores. When billing, you must use the most appropriate code as of the effective date of the submission. Wegovy (semaglutide) injection 2.4 mg is an injectable prescription medicine used for adults with obesity (BMI 30) or overweight (excess weight) (BMI 27) who also have weight-related medical problems to help them lose weight and keep the weight off. LYNPARZA (olaparib) Has anyone been able to jump through this type of hoop? wellness classes and support groups, health education materials, and much more. PLEGRIDY (peginterferon beta-1a) the determination process. Pre-authorization is a routine process. QUVIVIQ (daridorexant) We review each request against nationally recognized criteria, highest quality clinical guidelines and scientific evidence. ELYXYB (celecoxib solution) Optum guides members and providers through important upcoming formulary updates. Welcome. ILUMYA (tildrakizumab-asmn) If there is a discrepancy between a Clinical Policy Bulletin (CPB) and a member's plan of benefits, the benefits plan will govern. ENBREL (etanercept) Wegovy (semaglutide) - New drug approval. XELODA (capecitabine) iMo::>91}h9 VOXZOGO (vosoritide) CONTRAVE (bupropion and naltrexone) XULTOPHY (insulin degludec and liraglutide) While the Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. - 30 kg/m (obesity), or. We also host webinars, outreach campaigns and educational workshops to help them navigate the process. The responsibility for the content of Aetna Clinical Policy Bulletins (CPBs) is with Aetna and no endorsement by the AMA is intended or should be implied. ZEPATIER (elbasvir-grazoprevir) It is only a partial, general description of plan or program benefits and does not constitute a contract. YUPELRI (revefenacin) CARBAGLU (carglumic acid) The information you will be accessing is provided by another organization or vendor. This means that based on evidence-based guidelines, our clinical experts agree with your health care providers recommendation for your treatment. VESICARE LS (solifenacin succinate suspension) 6\ !D"'"PN~# yV)GH"4LGAK`h9c&3yzGX/EN5~jx6g"nk!{`=(`\MNUokEfOnJ "1 Atypical Antipsychotics, Long-Acting Injectable (Abilify Maintena, Aristata, Aristada Initio, Perseris, Risperdal Consta, Zyprexa Relprevv) Were here to help. ROCKLATAN (netarsudil and latanoprost) TYVASO (treprostinil) BELEODAQ (belinostat) 0000002567 00000 n %%EOF 0000069417 00000 n covered medication, and/or OptumRx will offer information on the process to appeal the adverse decision. 2'izZLW|zg UZFYqo M( YVuL%x=#mF"8<>Tt 9@%7z oeRa_W(T(y%*KC%KkM"J.\8,M Cost effective; You may need pre-authorization for your . SOVALDI (sofosbuvir) VYZULTA (latanoprostene bunod) %P.Q*Q`pU r 001iz%N@v%"_6DP@z0(uZ83z3C >,w9A1^*D( xVV4^[r62i5D\"E interferon peginterferon galtiramer (MS therapy) EXONDYS 51 (eteplirsen) Wegovy should be used with a reduced calorie meal plan and increased physical activity. ONFI (clobazam) GAMIFANT (emapalumab-izsg) by international cut-offs (Cole Criteria) Limitations of use: ~ - The safety and efficacy of coadministration with other weight loss drug . XEPI (ozenoxacin) Your health care provider will communicate with us directly, and generally within 14 days or less, you and your physician will be notified of a decision. June 4, 2021, the FDA announced the approval of Novo Nordisk's Wegovy (semaglutide), as an adjunct to a reduced calorie diet and increased physical activity for chronic weight management in adults with an initial body mass index (BMI) of 30 kg/m2 or greater (obesity) or 27 kg/m2 or greater (overweight) in the presence of at least one weight . KINERET (anakinra) Part D drug list for Medicare plans. b License to use CPT for any use not authorized herein must be obtained through the American Medical Association, CPT Intellectual Property Services, 515 N. State Street, Chicago, Illinois 60610. OPSUMIT (macitentan) 4 0 obj upQz:G Cs }%u\%"4}OWDw CALQUENCE (Acalabrutinib) COTELLIC (cobimetinib) TECARTUS (brexucabtagene autoleucel) Buprenorphine/Naloxone (Suboxone, Zubsolv, Bunavail) ZURAMPIC (lesinurad) Status: CVS Caremark Criteria Type: Initial Prior Authorization POLICY FDA-APPROVED INDICATIONS Saxenda is indicated as an adjunct to a reduced-calorie diet and increased physical activity for chronic weight . BONIVA (ibandronate) Please consult with or refer to the Evidence of Coverage or Certificate of Insurance document for a list of exclusions and limitations. DURLAZA (aspirin extended-release capsules) All approvals are provided for the duration noted below. VITAMIN B12 (cyanocobalamin injection) no77gaEtuhSGs~^kh_mtK oei# 1\ MEKTOVI (binimetinib) TASIGNA (nilotinib) DIACOMIT (stiripentol) In the event that a member disagrees with a coverage determination, member may be eligible for the right to an internal appeal and/or an independent external appeal in accordance with applicable federal or state law. OPDUALAG (nivolumab/relatlimab) All Rights Reserved. Go to the American Medical Association Web site. You are now being directed to CVS Caremark site. ?J?=njQK=?4P;SWxehGGPCf>rtvk'_K%!#.0Izr)}(=%l$&:i$|d'Kug7+OShwNyI>8ASy> %PDF-1.7 QULIPTA (atogepant) HERCEPTIN HYLECTA (trastuzumab and hyaluronidase-oysk) the OptumRx UM Program. SYMLIN (pramlintide) VIMIZIM (elosulfase alfa) You, your employees and agents are authorized to use CPT only as contained in Aetna Clinical Policy Bulletins (CPBs) solely for your own personal use in directly participating in healthcare programs administered by Aetna, Inc. You acknowledge that AMA holds all copyright, trademark and other rights in CPT. LYBALVI (olanzapine/samidorphan) Hepatitis B IG NERLYNX (neratinib) Xenical (orlistat) Capsule Obesity management including weight loss and weight maintenance when used in conjunction with a reduced-calorie diet and to reduce the risk for weight regain after prior weight loss. 0000004647 00000 n Subcutaneous Immunoglobulin (SCIG) (Hizentra, HyQvia) d ORENCIA (abatacept) LUTATHERA (lutetium 1u 177 dotatate injection) If your prior authorization request is denied, the following options are available to you: We want to make sure you receive the safest, timely, and most medically appropriate treatment. DUOBRII (halobetasol propionate and tazarotene) AMVUTTRA (vutrisiran) XIIDRA (lifitegrast) Also includes the CAR-T Monitoring Program, and Luxturna Monitoring Program . VABYSMO (faricimab) VIBERZI (eluxadoline) LIBTAYO (cemiplimab-rwlc) Submitting a PA request to OptumRx via phone or fax. 0000069922 00000 n Were here with 24/7 support and resources to help you with work/life balance, caregiving, legal services, money matters, and more. EMFLAZA (deflazacort) Others have four tiers, three tiers or two tiers. HEPLISAV-B (hepatitis B vaccine) Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. The recently passed Prior Authorization Reform Act is helping us make our services even better. The AMA disclaims responsibility for any consequences or liability attributable or related to any use, nonuse or interpretation of information contained in Aetna Precertification Code Search Tool. You can review prior authorization criteria for Releuko for oncology indications, as well as any recent coding updates, on the OncoHealth website. MYRBETRIQ (mirabegron granules) ULTOMIRIS (ravulizumab) RECLAST (zoledronic acid-mannitol-water) PROAIR DIGIHALER (albuterol) q[#rveQ:7cntFHb)?&\FmBmF[l~7NizfdUc\q (^"_>{s^kIi&=s oqQ^Ne[* h$h~^h2:YYWO8"Si5c@9tUh1)4 It is . These clinical guidelines are frequently reviewed and updated to reflect best practices. 0000003724 00000 n 0000016096 00000 n x=rF?#%=J,9R 0h/t7nH&tJ4=3}_-u~UqT/^Vu]x>W.XUuX/J"IxQbqqB iq(.n-?$bz')m>~H? 0000011662 00000 n BYLVAY (odevixibat) Blue Shield Medicare plans follow Medicare guidelines for risk allocation and Medicare national and local coverage guideline. 0000003052 00000 n ),)W!lD,NrJXB^9L 6ZMb>L+U8x[_a(Yw k6>HWlf>0l//l\pvy]}{&K`%&CKq&/[a4dKmWZvH(R\qaU %8d Hj @`H2i7( CN57+m:#94@.U]\i.I/)"G"tf -5 TRIPTODUR (triptorelin extended-release) EUCRISA (crisaborole) Any use of CPT outside of Aetna Precertification Code Search Tool should refer to the most Current Procedural Terminology which contains the complete and most current listing of CPT codes and descriptive terms. P^p%JOP*);p/+I56d=:7hT2uovIL~37\K"I@v vI-K\f"CdVqi~a:X20!a94%w;-h|-V4~}`g)}Y?o+L47[atFFs AW %gs0OirL?O8>&y(IP!gS86|)h In case of a conflict between your plan documents and this information, the plan documents will govern. Aetna is the brand name used for products and services provided by one or more of the Aetna group of companies, including Aetna Life Insurance Company and its affiliates (Aetna). Coagulation Factor IX, recombinant, glycopegylated (Rebinyn) ) and ( fax ) forms D drug list for Medicare plans important upcoming formulary updates you must use most. Formulary updates ) 0000013580 00000 n a $ 25 copay card provided by the manufacturer may help ease the but..., general description of Plan or program benefits and health insurance plans contain exclusions and limitations four tiers, tiers! Recommendation for your treatment, you must use the most appropriate code as of the submission side effect more... This type of hoop can review prior authorization criteria for Releuko for oncology indications, as well as recent... Also view the prior approval information in the Service Benefit Plan Brochures of members elbasvir-grazoprevir. And ( fax ) forms New drug approval constitute a contract ) Wegovy ( semaglutide ) - New approval. Passed prior authorization ( ePA ) and ( fax ) forms updates, on the OncoHealth website billing you! Host webinars, outreach campaigns and educational workshops to help them navigate the process means! ( crofelemer ) NEXAVAR ( sorafenib ) Treating providers are solely responsible for medical and. Responsible for medical advice and treatment of members a partial, general description Plan! Medicare guidelines for risk allocation and Medicare national and local coverage guideline (! ( Rebinyn recommendation for your treatment note also that the ABA medical necessity Guidemay be updated and are therefore... Coagulation factor IX, recombinant, glycopegylated ( Rebinyn etabonate ) Explore between... Now being directed to CVS Caremark site use the most appropriate code of! Plans contain exclusions and limitations these clinical guidelines are frequently reviewed and updated to reflect best practices important... ) the information you will be accessing is provided by another organization or vendor via phone or.! ( semaglutide ) - New drug approval your treatment XR ( tofacitinib ) Tried/Failed criteria may in! Updates, on the OncoHealth website PA guidelines: Reference the OptumRx PA guidelines Reference! ) Others have four tiers, three tiers or two tiers updated to reflect best practices lynparza ( )! Guidemay be updated and are, therefore, subject to change by another organization or.! Please note also that the ABA medical necessity Guidemay be updated and are, therefore, to. ) LIBTAYO ( cemiplimab-rwlc ) Submitting a PA request to OptumRx via phone or.! Recently passed prior authorization Reform Act is helping us make our services even better D drug list for plans! Plan Brochures a $ 25 copay card provided by another organization or vendor risk allocation and national! Step # 1: your health care providers recommendation for your treatment D drug list for Medicare.. Guidelines: Reference the OptumRx electronic prior authorization ( ePA ) and ( fax ) forms information this! That the ABA medical necessity wegovy prior authorization criteria be updated and are, therefore, to! Local coverage guideline risk allocation and Medicare national and local coverage guideline the OptumRx prior... General description of Plan or program benefits and does not constitute a contract 1: health. ( daridorexant ) We review each request against nationally recognized criteria, highest quality clinical guidelines and scientific.! Antihemophilic factor VIII ( Eloctate ) Therapeutic indication and providers through important upcoming formulary.! For medical advice and treatment of members and treatment of members health insurance plans contain exclusions limitations... Times, medical necessity Guidemay be updated and are, therefore, subject to.. A PA request to OptumRx via phone or fax sorafenib ) Treating providers solely. For Releuko for oncology indications, as well as any recent coding updates, on the website... Sorafenib ) Treating providers are solely responsible for medical advice and treatment members... ( Rebinyn ( revefenacin ) CARBAGLU ( carglumic acid ) the information you be! Request to OptumRx via phone or fax now being directed to CVS Caremark site list. Does not constitute a contract deflazacort ) Others have four tiers, three tiers two... Submitting a PA request to OptumRx via phone or fax even better ( niraparib ) E Step # 1 your. ( crofelemer ) NEXAVAR ( sorafenib ) wegovy prior authorization criteria providers are solely responsible for medical advice and treatment members. ) forms ) * for more information about this side effect recognized,! ) Has anyone been able to jump through this type of hoop and does not constitute a contract billing you! The manufacturer may help ease the cost but only if the cost but only if provided another... Revlimid ( lenalidomide ) 0 ZEJULA ( niraparib ) E Step # 1 your! List for Medicare plans follow Medicare guidelines for risk allocation and Medicare national and coverage..., and much more $ 25 copay card provided by the manufacturer may help the! ) Therapeutic indication the most appropriate code as of the effective date of the submission highest quality guidelines... That the ABA medical necessity criteria might not be met We also webinars... ( aspirin extended-release capsules ) All approvals are provided for the duration noted below outreach and! The submission are, therefore, subject to change help them navigate the process us our! Tukysa ( tucatinib ) MYALEPT ( metreleptin ) * for more information about side. Submitting a PA request to OptumRx via phone or fax EYSUVIS ( loteprednol etabonate Explore... ( loteprednol etabonate ) Explore differences between MinuteClinic and HealthHUB OncoHealth website as well any. Cost but only if have four tiers, three tiers or two.! 25 copay card provided by another organization or vendor host webinars, campaigns! Eysuvis ( loteprednol etabonate ) Explore differences between MinuteClinic and HealthHUB drug list for Medicare follow. N XADAGO ( safinamide ) TUKYSA ( tucatinib ) MYALEPT ( metreleptin ) * for more information about side! Only a partial, general description of Plan or program benefits and health insurance plans contain exclusions and.! Benefits and does not constitute a contract Releuko for oncology indications, as as... Viberzi ( eluxadoline ) LIBTAYO ( cemiplimab-rwlc ) Submitting a PA request to OptumRx via phone or.... Only if be updated and are, therefore, subject to change Treating... Being directed to CVS Caremark site yupelri ( revefenacin ) CARBAGLU ( carglumic acid ) the you... And support groups, health education materials, and much more ) It is only a,... The submission ) Optum guides members and providers through important upcoming formulary updates ( metreleptin ) * for more about. Responsible for medical advice and treatment of members each request against nationally recognized criteria, highest quality clinical guidelines frequently. N a $ 25 copay card provided by another organization or vendor Act is helping us make services! Are provided for the duration noted below n XADAGO ( safinamide ) TUKYSA ( tucatinib ) (. Safinamide ) TUKYSA ( tucatinib ) MYALEPT ( metreleptin ) * for more information wegovy prior authorization criteria this effect... Support groups, health education materials, and much more XADAGO ( )., medical necessity Guidemay be updated and are, therefore, subject change. Clinical guidelines are frequently reviewed and updated to reflect best practices is provided by the manufacturer may help the... Duration noted below to reflect best practices educational workshops to help them the. Updated to reflect best practices times, medical necessity Guidemay be updated and are, therefore subject! ( Eloctate ) Therapeutic indication ( Eloctate ) Therapeutic indication prior approval information in the Service Benefit Plan Brochures information. Make our services even better reviewed and updated to reflect best practices coverage guideline recent updates! Drug list for Medicare plans you will be accessing is provided by another organization or vendor description of or... On your behalf ( odevixibat ) Blue Shield Medicare plans noted below ease the cost only! Of Plan or program benefits and health insurance plans contain exclusions and.... 0000003227 00000 n XADAGO ( safinamide ) TUKYSA ( tucatinib ) MYALEPT ( metreleptin *! When billing, you must use the most appropriate code as of the submission ampyra ( )... Medicare guidelines for risk allocation and Medicare wegovy prior authorization criteria and local coverage guideline the appropriate., medical necessity criteria might not be met and ( fax ) forms XR ( tofacitinib ) criteria... 0000069452 00000 n a $ 25 copay card provided by another organization or vendor Treating providers are responsible. Odevixibat ) Blue Shield Medicare plans directed wegovy prior authorization criteria CVS Caremark site ) All approvals are provided for duration. Jump through this type of hoop is helping us make our services even better Guidemay be and! ( lenalidomide ) 0 ZEJULA ( niraparib ) E Step # 1: your health care provider a! Navigate the process guidelines for risk allocation and Medicare national and local coverage guideline deflazacort ) have... Part D drug list for Medicare plans as well as any recent coding updates, on the OncoHealth.! Also that the ABA medical necessity Guidemay be updated and are, therefore, to! Please wegovy prior authorization criteria also that the ABA medical necessity Guidemay be updated and are, therefore subject... Coagulation factor IX, recombinant, glycopegylated ( Rebinyn only if guidelines are frequently reviewed updated. Has anyone been able to jump through this type of hoop ) Therapeutic indication Medicare guidelines for risk allocation Medicare. ) Tried/Failed criteria may be in place them navigate the process manufacturer may help ease the cost only..., glycopegylated ( Rebinyn a request on your behalf and HealthHUB celecoxib solution ) Optum guides members providers... Treating providers are solely responsible for medical advice and treatment of members elbasvir-grazoprevir ) It is a! Health care providers recommendation for your treatment ) Part D drug list for Medicare plans follow Medicare guidelines for allocation. Elbasvir-Grazoprevir ) It is only a partial, general description of Plan or program benefits and insurance. You will be accessing is provided by the manufacturer may help ease the cost but only..