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Drug Management Program

MoreCare has a Drug Management Program (DMP) to help you safely use opioid medications. Opioids are a class of drugs that include pain relievers available by prescription only, such as oxycodone (OxyContin®), hydrocodone (Vicodin®), codeine, morphine, and many others. Opioid pain medications can help with certain types of pain, but have serious risks like addiction, overdose, and death. These risks are increased when opioids are obtained from multiple doctors or pharmacies, and when opioids are taken with certain other medications like benzodiazepines (commonly used for anxiety and sleep). If you use opioid medications that you get from several doctors or pharmacies, we may talk to your doctors to make sure their use is appropriate and medically necessary. Working with your doctors, we’ll decide if you are at risk for misusing or abusing opioid or benzodiazepine medications, and limit how you can get those medications. The limitations may be:

  • Requiring you to get all your prescriptions for opioid or benzodiazepine medications from one pharmacy
  • Requiring you to get all your prescriptions for opioid or benzodiazepine medications from one doctor
  • Limiting the amount of opioid or benzodiazepine medications we will cover for you

If we decide that one or more of these limitations should apply to you, we will send you a letter in advance. The letter will have information explaining the terms of the limitations we think should apply. You will have an opportunity to tell us which doctors or pharmacies you prefer to use. If you think we made a mistake or disagree with our determination that you are at-risk for prescription drug abuse or the limitation, you and your prescriber have the right to ask us for an appeal. Refer to the plan’s Evidence of Coverage booklet for information about how to ask for an appeal.

The DMP may not apply to members that have certain medical conditions, such as cancer, receiving hospice, palliative or end-of-life care, or live in a long-term care facility.

For Frequently Asked Questions about MoreCare’s Drug Management Program and Safe Opioid Usage, click the link below
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