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member news
Change in access
to some medicines
S
tarting October 6, access
to some types of pain
medicines will change. is
will a ect pain medicines like
Vicodin, Norco and Lortab. It will
also a ect cough medicines like
Tussionex, Hycodan, Pennkinetic,
Mycodone and Tussigon.
e change is being made
by a federal agency, the Drug
Enforcement Administration
(DEA). It is not a decision of the
Alliance. e DEA is changing
medicines that are hydrocodone
combination products (HCPs) from
Schedule 3 to Schedule 2.
What does this change
mean?
Being Schedule 2 means
that prescriptions for these
medicines will need to be written
on tamper-resistant prescription
forms. ey cannot be called in to
pharmacies. And the prescriptions
will only be good for one ll. No
re lls are allowed. But if you already
have an active prescription for one
of these medicines that has re lls
left, you can still get the re lls if:
e prescription was written
before October 6, 2014
e re lls are dispensed before
April 8, 2015
GETTING AN APPOINTMENT
How long should you have to wait?
W
e know it is important
for you to get care when
you need it. But it is not
always possible for a doctor to
see you right away. You may have
to wait longer for some types of
appointments than others. For
example, you should be able to get
an urgent care (care when you are
sick) appointment sooner than an
appointment for a regular checkup.
We work with the doctors and
clinics in our network to make sure
you can get care when you need it.
We have always done this because
we know it is important.
Health plans in California have to
meet certain standards for access
to care. e regulations to put this
law into place are called the Timely
Access to Non-Emergency Health
Care Services standards. ere are
di erent standards for di erent
types of appointments.
In the chart below are the
standards for di erent types of
appointments. e waiting times
for an appointment may be longer
if the provider feels that it will not
harm your health if you have a
longer wait.
If you feel you are not getting
care when you need it, call Member
Services at
1-800-700-3874
.
Type of care you need Time to get an appointment
Urgent care
Within 48 hours of when you call
Non-urgent primary care
Within 10 business days of when you call
Non-urgent specialty care
Within 15 business days of when you call
Non-physician, non-urgent
mental health care
Within 10 business days of when you call
Non-urgent diagnostic services Within 15 business days of when you call
TAKE ACTION.
Call your
Primary Care Provider if you
have any questions about how
this change will affect you.
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living
healthy