Prescription Drugs

Make sure you have what you need

We are making it easier for you to get increased access to the prescription drugs you will need during this period of emergency by:

  • Allowing for early refill of prescription medication without waiting to finish your current fill
  • Allowing refill for up to a 90-day supply to the extent consistent with clinical guidelines, except for controlled substances (subject to CMS rules)

Hydroxychloroquine and Chloroquine Coverage & Availability

Hydroxychloroquine and chloroquine coverage:

  • Prior authorization is required for coverage of chloroquine and hydroxychloroquine tablets for members initiating a new course of treatment. Coverage is limited to 28 tablets for approval related to COVID-19.
  • No action is required for members who have previously been taking these drugs. They may obtain the prescribed supply up to their benefit limit.

Hydroxychloroquine​ and chloroquine drug shortage:

  • Hydroxychloroquine and chloroquine are currently in short supply. 
  • If you take hydroxychloroquine or chloroquine regularly for rheumatoid arthritis, lupus or another chronic condition, and are running out of the drug, we encourage you to call your pharmacist to try to locate additional supplies. 
  • The Tufts Health Plan Pharmacy team and CVS Health do not have access to the inventories that are available in specific pharmacies, or the ability to find additional drug supplies. 
  • If you are unable to find an additional supply, we encourage you to call the doctor who prescribed the drug to learn about alternative medication options before you run out.

Assisted Reproductive Technology (ART)

The following applies to all Tufts Health Plan products:

  • Tufts Health Plan will extend authorized cycles and testing intervals for members receiving infertility treatments. Note: Prior authorization for infertility services and testing intervals valid as of March 5, 2020 are extended for cycle initiations that occur no later than August 1, 2020.
  • Tufts Health Plan will not count a canceled cycle, due to COVID-19 exposure, illness or factors outside a provider’s control, towards a member’s lifetime maximum cycle limit for all products where ART services are a covered benefit with lifetime limits. Note: These situations will be reviewed on a case-by-case basis.