2024 Evidence of Coverage for UnitedHealthcare® Group Medicare Advantage PEBB Complete (PPO) Chapter 5: Using the plan’s coverage for Part D prescription drugs 154 When changes to the Drug List occur, we post information on our website about those changes. We also update our website on a regularly scheduled basis. Below we point out the times that you would get direct notice if changes are made to a drug that you are taking. Changes to your drug coverage that affect you during the current plan year · A new generic drug replaces a brand name drug on the Drug List (or we change the cost- sharing tier or add new restrictions to the brand name drug or both) - We may immediately remove a brand name drug on our Drug List if we are replacing it with a newly approved generic version of the same drug. The generic drug will appear on the same or lower cost-sharing tier and with the same or fewer restrictions. We may decide to keep the brand name drug on our Drug List, but immediately move it to a higher cost-sharing tier or add new restrictions or both when the new generic is added. - We may not tell you in advance before we make that change—even if you are currently taking the brand name drug. If you are taking the brand name drug at the time we make the change, we will provide you with information about the specific change(s). This will also include information on the steps you may take to request an exception to cover the brand name drug. You may not get this notice before we make the change. - You or your prescriber can ask us to make an exception and continue to cover the brand name drug for you. For information on how to ask for an exception, see Chapter 9. · Unsafe drugs and other drugs on the Drug List that are withdrawn from the market - Sometimes a drug may be deemed unsafe or taken off the market for another reason. If this happens, we may immediately remove the drug from the Drug List. If you are taking that drug, we will tell you right away. - Your prescriber will also know about this change, and can work with you to find another drug for your condition. · Other changes to drugs on the Drug List - We may make other changes once the year has started that affect drugs you are taking. For example, we might add a generic drug that is not new to the market to replace a brand name drug on the Drug List or change the cost-sharing tier or add new restrictions to the brand name drug or both. We also might make changes based on FDA boxed warnings or new clinical guidelines recognized by Medicare. - For these changes, we must give you at least 30-days’ advance notice of the change or give you notice of the change and a 30-day refill of the drug you are taking at a network pharmacy. - After you receive notice of the change, you should work with your provider to switch to a different drug that we cover or to satisfy any new restrictions on the drug you are taking. - You or your prescriber can ask us to make an exception and continue to cover the drug for you. For information on how to ask for an exception, see Chapter 9. Changes to the Drug List that do not affect you during this plan year