2024 Evidence of Coverage for UnitedHealthcare® Group Medicare Advantage PEBB Balance (PPO) Chapter 5: Using the plan’s coverage for Part D prescription drugs 160 In the event you either revoke your hospice election or are discharged from hospice, our plan should cover your drugs as explained in this document. To prevent any delays at a pharmacy when your Medicare hospice benefit ends, bring documentation to the pharmacy to verify your revocation or discharge. Section 10 Programs on drug safety and managing medications Section 10.1 Programs to help members use drugs safely We conduct drug use reviews for our members to help make sure that they are getting safe and appropriate care. We do a review each time you fill a prescription. We also review our records on a regular basis. During these reviews, we look for potential problems such as: · Possible medication errors · Drugs that may not be necessary because you are taking another drug to treat the same condition · Drugs that may not be safe or appropriate because of your age or gender · Certain combinations of drugs that could harm you if taken at the same time · Prescriptions for drugs that have ingredients you are allergic to · Possible errors in the amount (dosage) of a drug you are taking · Unsafe amounts of opioid pain medications If we see a possible problem in your use of medications, we will work with your provider to correct the problem. Section 10.2 Drug Management Program (DMP) to help members safely use their opioid medications We have a program that helps make sure members safely use prescription opioids and other frequently abused medications. This program is called a Drug Management Program (DMP). If you use opioid medications that you get from several doctors or pharmacies, or if you had a recent opioid overdose, we may talk to your doctors to make sure your use of opioid medications is appropriate and medically necessary. Working with your doctors, if we decide your use of prescription opioid or benzodiazepine medications may not be safe, we may limit how you can get those medications. If we place you in our DMP, the limitations may be: · Requiring you to get all your prescriptions for opioid or benzodiazepine medications from a certain pharmacy(ies) · Requiring you to get all your prescriptions for opioid or benzodiazepine medications from a certain doctor(s) · Limiting the amount of opioid or benzodiazepine medications we will cover for you If we plan on limiting how you may get these medications or how much you can get, we will send you a letter in advance. The letter will tell you if we will limit coverage of these drugs for you, or if you’ll be required to get the prescriptions for these drugs only from a specific doctor or pharmacy.