News and Updates

Updated 1/19/22

Jan. 19, 2022: Some of the information below has changed since first publication. As the federal mandate for health insurers to cover the cost of rapid antigen COVID-19 tests is implemented nationwide, different pharmacies are reimburing in different ways. U-M Benefits is working diligently with its pharmacy benefit manager, Magellan Rx, and its network pharmacies to standardize this benefit.

Watch this space for updates.

At-Home COVID 19 Tests Covered by Health Plans

As of Jan. 15, 2022, U-M’s Prescription Drug Plan covers FDA-approved rapid antigen COVID-19 tests at retail pharmacies. This is part of a federal mandate to fight the nationwide surge of omicron-related infections.

Each member is eligible for up to eight tests each month, per covered individual for the duration of the mandate.

The federal mandate requires pharmacies to cover the tests at no cost to the member or dependents. As members have purchased tests, however, different pharmacies are processing the benefit in different ways. 

Call your pharmacy before you make the trip to find out how it's processing the benefit. You'll know what to expect when you get there. 

Steps for Reimbursement

Purchase at the pharmacy, in person

  • Show your prescription drug card at the pharmacy counter.
  • You may be told that you must pay for the tests, then file for reimbursement. Or, your card may be accepted as payment. Members report different experiences at different pharmacies. 
  • If you paid when you purchased the tests, save the original receipt, fill out a prescription drug claim form, then send both to Magellan Rx. 

Purchase online

  • Pay for the purchase at the time of order. 
  • Save your original receipt, fill out a prescription drug claim form, then send both to Magellan Rx. 
  • Tests purchased secondhand from resellers are not covered. 

For more details, visit the COVID-19 Information for Employees page.

View more details and frequently asked questions under "Rapid COVID-19 Test Reimbursement."

Updated 11/8/21

Check this page frequently for the latest information regarding the Prescription Drug Plan formulary, changes to coverage policies, and other relevant news for plan members.

Drug Recalls

The University of Michigan's Prescription Drug Plan will keep members up-to-date with important information regarding drug recalls. Members potentially impacted by a drug recall related to a medication's safety or efficacy may receive a letter from Magellan Rx with information about the recall, and what they should do for next steps. For more information on recent drug recalls, visit Magellan Rx's website or visit the FDA’s website.

COVID-19 Vaccine Updates

The COVID-19 vaccine is a covered pharmacy-administered vaccine. U-M’s benefits plans cover approved vaccinations under both your pharmacy through the U-M Prescription Drug Plan and through your U-M health plan. Approved vaccines require no co-pay on your part. When receiving your vaccine at a pharmacy, provide either your medical or drug plan ID card. To avoid confusion, don't use both cards at the same time. Learn about COVID-19 vaccine eligibility and availability.

Pharmacy Benefits and Advisory Committee (PBAC) Updates

The Pharmacy Benefits and Advisory Committee (PBAC), consisting of clinical subject matter experts within Michigan Medicine and the University of Michigan, meets regularly to review and approve changes to the Prescription Drug Plan formulary. Check the formulary for up to date formulary status. Formulary status is subject to change. Here are the latest updates.

May 2022

New Drug Products Added to Formulary

Effective May 2, 2022, the following changes will be made to the Prescription Drug Plan’s formulary. Review the formulary.

  • Daridorexant (Quviviq) – Tier 3, ST, QL, age limit (age ≥ 18 years)
  • Pacritinib (Vonjo) – Tier 2, Specialty, PA, QL, split fill
  • Mitapivat (Pyrukynd) – Tier 2, LDD, PA, QL
  • Semaglutide 8 mg/3 ml pens (Ozempic) – Tier 2, ST, QL, age limit (age ≥ 18 years)
  • Upadacitinib 45 mg tablets (Rinvoq) – Tier 2, Specialty, PA, QL
  • Siponimod 1 mg (Mayzent) – Tier 2, QL, Specialty
  • Tenofovir alafenamide/Emtricitabine 120-15 mg tablet (Descovy) – Tier 2, Specialty/HIV, PA, QL
  • Naloxone 5 mg/0.5 ml syringe (Zimhi) – Tier 3, QL

New Generics and Biosimilars Added to Formulary

  • Digoxin 62.5 mcg tablet (generic for Lanoxin)
  • Lenalidomide 5, 10, 15, 25 mg capsule (generic for Revlimid)
  • Diclofenac potassium 25 mg capsule (generic for Zipsor)
  • Lacosamide 50, 100, 150, 200 mg tablet (generic for Vimpat)
  • Baclofen 5 mg/5 mL oral solution (generic for Ozobax)

March 2022

New Drug Products Added to Formulary

Effective March 1, 2022, the following changes will be made to the Prescription Drug Plan’s formulary. Review the formulary. 

  • Tralokinumab (Adbry) – Tier 3, Specialty, PA, QL

  • Abrocitinib (Cibinqo) – Tier 3, Specialty, PA, QL
  • Ropeginterferon Alfa-2B-NJFT (Besremi) – Tier 3, LDD, PA, QL
  • Lonapegsomatropin (Skytrofa) – Tier 3, Specialty, PA
  • Vosoritide (Voxzogo) – Tier 2, LDD, PA, QL

New Generics and Biosimilars Added to Formulary

  • Cyclosporine ophthalmic emulsion (generic for Restasis)

  • Maraviroc 150 mg and 300 mg tablets (generic for Selzentry)
  • Brimonidine-Timolol 0.2%-0.5% ophthalmic solution (generic for Combigan)

February 2022

New Drug Products Added to Formulary

Effective Feb. 1, 2022, the following changes will be made to the Prescription Drug Plan’s formulary. Review the formulary. 

  • Avacopan tablets (Tavneos) – Tier 2, LDD, PA, QL

  • Maribavir tablets (Livtencity) – Tier 2, LDD, PA, QL
  • Olanzapine + samidorphan (Lybalvi) – Tier 3, PA, QL

New Generics and Biosimilars Added to Formulary

  • Glycopyrrolate 1 mg/5 ml solution (generic for Cuvposa)

  • Naloxone hydrochloride 4 mg nasal spray (generic for Narcan)

  • Norethindrone-ethinyl estradiol 1-35 28 tablet (generic for Nylia)

January 2022

New Drug Products Added to Formulary

Effective Jan. 1, 2022, the following changes will be made to the Prescription Drug Plan’s formulary. Review the formulary. 

  • Varenicline Tartrate nasal spray (Tyrvaya) – Tier 2, PA, QL

  • Odevixibat (Bylvay) – Tier 2, LDD, PA

  • Maralixibat (Livmarli) – Tier 2, LDD, PA

  • Belzutifan (Welireg) – Tier 2, LDD, PA, QL

  • Asciminib (Scemblix) – Tier 2, PA, QL

New Generics and Biosimilars Added to Formulary

  • Glycopyrrolate 1 mg/5 ml solution (generic for Cuvposa)
  • Naloxone hydrochloride 4 mg nasal spray (generic for Narcan)
  • Norethindrone-ethinyl estradiol 1-35 28 tablet (generic for Nylia)

November 2021

New Drug Products Added to Formulary

Effective Nov. 1, 2021, the following changes will be made to the Prescription Drug Plan’s formulary. Review the formulary. 

  • Ruxolitinib cream (Opzelura) – Tier 3, Specialty, PA, QL
  • Atogepant (Qulipta) – Tier 3, Specialty, PA, QL
  • Mobocertinib (Exkivity) – Tier 2, Specialty, PA, QL

New Generics and Biosimilars Added to Formulary

  • Insulin Glargine-yfgn (biosimilar for Semglee, Lantus)
  • Desmopressin 1.5 mg/mL Spray (generic for Stimate)
  • Nebivolol tablets (generic for Bystolic)
  • Varenicline tablets (generic for Chantix)
  • Paroxetine suspension (generic for Paxil suspension)
  • Everolimus tablets, tablet suspension (generics for Afinitor, Afinitor Disperz)
  • Difluprednate 0.05% eye drops (generic for Durezol)

October 2021

Mail Order Update

As of Friday, Oct. 22, members will no longer be able to order their 90-day prescription drugs on the NoviXus/U-M website. These orders will be taken only on the Birdi website, umich.birdirx.com. Work on the Birdi app continues, with a goal to go live in early 2022. The NoviXus app is being phased out of the App Store and Google Play within the next month and will soon be unusable, so plan accordingly. 

September 2021

New Drug Products Added to Formulary

Effective Sept. 1, 2021, the following changes will be made to the Prescription Drug Plan’s formulary. Review the formulary. 

  • Pegcetacopian (Empaveli) – Tier 2, LDD, PA, QL
  • Infigratinib (Truseltiq) – Tier 2, Specialty, PA, QL
  • Finerenone (Kerendia) – Tier 3, PA, QL
  • Ibrexafungerp (Brexafemme) – Tier 3, PA, QL
  • Relugolix, Estradiol, Norethindrone (Myfembree) – Tier 2, PA, QL
  • Belumosudil (Rezurock) – Tier 3, PA, QL
  • Naloxone (Kloxxado) nasal spray – Tier 2, QL
  • Mirabegron (Myrbetriq granules) 8 mg/mL suspension – Tier 3, QL
  • Riluzole (Exservan) film – Tier 2, PA, QL

New Generics Added to Formulary

  • Formoterol nebulized vials (generic for Perforomist)
  • Enalapril 1 mg/mL oral solution (generic for Epaned)
  • Sajazir 30 mg/3 mL syringe (branded generic for Firazyr)
  • Sunitinib capsules (generic for Sutent)

July 2021

U-M Mail Order Pharmacy Name Change Effective July 1

As of July 1, 2021, NoviXus Pharmacy Services, U-M’s mail order pharmacy, will be known as Birdi. Although the name has changed, services will continue without interruption. No action on your part is needed. Learn more about the name change. 

New Drug Products Added to Formulary

Effective July 1, 2021, the following changes will be made to the Prescription Drug Plan’s formulary. Review the formulary.

  • Semaglutide (Wegovy) – Tier 2, PA, QL
  • Ferric Maltol (Accrufer) – Tier 3, PA, QL
  • Mannitol (Bronchitol) – Tier 3, Specialty, PA, QL

New Generics Added to Formulary

  • Arformoterol Tartrate Solution (Generic for Brovana)
  • Bepotastine 1.5% Eye Drops (Generic for Bepreve)
  • Rufinamide 200 mg, 400 mg Tablets (Generic for Banzel)

June 2021

New Drug Products Added to Formulary

Effective June 1, 2021, the following changes will be made to the Prescription Drug Plan’s formulary. Review the formulary.

  • Viloxazine (Qelbree) – Tier 3, ST, QL
  • Serdexmethylphenidate and dexmethylphenidate (Azstarys) – Tier 3, PA, QL
  • Ponesimod (Ponvory) – Tier 3, Specialty, PA, QL
  • Drospirenone and Estetrol Tablets (Nextstellis) – Tier 3, ST, QL
  • Omalizumab (Xolair) – Tier 2, Specialty, PA

New Generics Added to Formulary

  • Pregabalin ER (Generic for Lyrica CR) Tablets

May 2021

Mail Order Pharmacy Service Name to Change July 1

As of July 1, 2021, NoviXus Pharmacy Services, U-M’s mail order pharmacy, will be known as Birdi. Although the name will change, services will continue without interruption. No action on your part is needed during this transition. Learn more about the name change.

April 2021

New Drug Products Added to Formulary

Effective April 1, 2021, the following changes will be made to the Prescription Drug Plan’s formulary. Review the formulary.

  • Tepotinib (Tepmetko) – Tier 2, Specialty, PA, QL, Split-Fill
  • Umbralisib (Ukoniq) – Tier 2, Specialty, PA, QL, Split-Fill
  • Tivozanib (Fotivda) – Tier 3, Specialty, PA, QL

New Generics Added to Formulary

  • Zafemy Contraceptive Patch (Generic for Xulane)
  • Loteprednol 0.5% Gel (Generic for Lotemax)
  • Brinzolamide 1% (Generic for Azopt)
  • Hydrocodone ER (Generic for Hysingla ER)