News and Updates

Updated 4/20/24

Weight Loss Prescription Drug Coverage to Change May 1, 2024

Starting May 1, 2024, the U-M Prescription Drug Plan will cover a maximum lifetime benefit of two years (i.e., 24 one-month fills) for any combination of GLP-1 (weight loss) drugs when prescribed only for the diagnosis of weight loss. This change applies only to injectable doses and does not include the use of GLP-1s for diabetes or the oral (pill) form. 

The 24-month benefit applies to prescriptions filled on or after May 1, 2024.

View more information on the Lifetime Drug Limits webpage

Updated 10/26/23

Tier 3 Copay to Increase Jan. 1, 2024

The tier 3 copay for members who have the U-M Prescription Drug Plan will increase from $45 to $75 as of Jan. 1, 2024. For details, see the 2024 Open Enrollment handbook

Updated 5/12/23

COVID-19 Medication, Test Coverage Changes

Effective May 12, 2023, COVID-19 treatment drugs Paxlovid and its generics, nirmatrelvir/ritonavir, continue to be covered by the U-M Prescription Drug Plan, with no member cost-share as long as the U.S. government pays for these products. 

Also effective May 12, 2023, over-the-counter rapid antigen COVID-19 tests are no longer covered by U-M’s Prescription Drug Plan. Members have through May 2024 to submit reimbursement claims to Magellan Rx for eligible, previously purchased test kits.

Updated 12/22/22

Weight Loss GLP-1 Coverage Tier Update (effective March 1, 2023)

Effective March 1, 2023, GLP-1 weight loss medications (i.e., Wegovy and Saxenda), will be considered non-preferred brand (tier 3) medications, and require a higher member copay.

If you are interested in using a similar formulary product with a lower copay, please discuss the preferred alternative product(s) listed below with your doctor or pharmacist.

Similar products may include:

  • Phentermine tablets – generic (tier 1), lowest copay
  • Bupropion-naltrexone oral tablets (Contrave) – preferred brand (tier 2), lower copay
  • Phentermine-topiramate oral capsules (Qsymia) – preferred brand (tier 2), lower copay

Pancreatic Enzyme Replacement Drugs Reclassified as of Jan. 1, 2023

Effective Jan. 1, 2023, pancreatic enzyme replacement medications (i.e., Creon, ZenPep, Viokace, Pancreaze, and Pertzye) will be reclassified as medications dispensed through U-M's specialty pharmacy. These medications require special storage and handling, have special administration requirements, necessitate close monitoring, and/or are high cost.

Please note: Copays and prior authorizations will stay the same.

  • Michigan residents: This change will require the use of the Michigan Medicine Specialty Pharmacy for future fills.
  • Non-Michigan residents: This change will require the use of Magellan Rx Specialty Pharmacy or Birdi for future fills. Each of these pharmacies offers free shipping.

These medications are limited to a maximum 34-day supply per fill.