navitus drug formulary 2022

Note: Most Dean Health Plan Large Groups use the Select 3-Tier Formulary. Putting People First. Below is the Costco Health Solutions Preferred formulary list. Step therapy is an effective tool for ensuring that you receive safe, effective, high-quality medications at a lower cost. All rights reserved. For EOCCO member information, please visit eocco.com/providers. Therapeutic classes are a group of similar drugs and have the same effect in the body. Please contact the Customer Care toll free number listed on your pharmacy benefit member ID card or call Navitus Customer Care at 1-844-268-9789. 1796 0 obj <>stream Customer Service Pharmacy Directories. Some examples are below. By guiding you to your lowest cost options, we offer flexibility and choice in helping determine the right medication for you. Despite needing prescription drugs to manage their health, many adults have reported not taking their medications as prescribed at least once in the past year because of cost putting their well-being at risk.1 Even more, 78% of Americans are personally worried a great deal or fair amount about the availability and affordability of healthcare.2 The humanity has been lost. The card will only be mailed for new enrollees. If unsure which Navitus documents apply to your patient, please contact Pharmacy Services at 844-235-8017. The Formulary helps you find lower-cost alternatives. The list also includes symbols. We supported our clients in preferring lower-net-cost options, including . * Enter the first three letters of the drug name in the search field. This helps stabilize and ultimately lower premiums for our members. Copyright 2022 Navitus All rights reserved, Key Findings: 2021 Navitus Drug Trend Report. Key drivers of trend will be in the non-specialty drug space to include diabetic agents, asthma treatments, HIV drugs and migraine medications. This week we provide an overview of our 2021 drug trend and client savings with insights for 2022 and beyond. Once you have logged in with your user name and password, you will see the homepage of the Navi-Gate website. Copyright 2023 Navitus Health Solutions. Kaiser Permanente. If you have coverage through your work, you can ask your employer directly. This means that even though a drug is listed on this formulary, it may not be covered by your specific benefit plan. It contracts with pharmacies and builds and maintains drug formularies. The covered OTC drugs are listed on your Formulary. The Formulary helps you find lower-cost alternatives. The goal of the Costco Health Solutions formulary, also known as a preferred drug list is used to help members and prescribers to make the best medication decision in terms of safety, efficacy, cost effectiveness and overall value. This list of chapters and page numbers is your starting point. Dear valued member, We are writing to acknowledge and apologize for the problems many members of the UC community are experiencing with Navitus Health, a new administrator of pharmacy benefits for . Sign-up for our free Medicare Part D Newsletter, Use the Online Calculators, FAQs or contact us through our Helpdesk -- Powered by Q1Group LLC Acknowledge any potential conflict of interest, Describe the methodology of guideline development, Emphasize inclusion of peer-reviewed publications and evidence-based research, Incorporate widely-accepted medical practice, Focus primarily on expert or consensus-based opinion. Operations Division - Claims You'll also have access to: Note: Prescription benefits may not be available from UMR through your employer. You can search the Vantage formulary to see if your drugs are covered according to drug tier, quantity limit (QL) and if prior authorization (PA) from Vantage is required . Drug pricing. However, there are still a number of pharmacies where your Navitus discounts are still available, including Walgreens, Walmart, and Kroger where you may see greater discounts. You can download a Quick Reference Formulary or a Complete Formulary. Formularies. You can select from these formularies based on the PreferredOne product. Or click here to access our online searchable directory. Our mission is to improve member health and minimize their out-of-pocket , Health1 hours ago WebYour formulary is provided with your new member materials. To learn more about Moda Health pharmacy benefits, including formularies and medication tiers, please log in Moda Health's Benefit Tracker or contact Moda Health Pharmacy Customer Service at 503-243-3960 or toll-free at 888-361-1610. Health8 hours ago WebWe Are HealthNow. Navitus uses a Pharmacy and Therapeutics (P&T) Committee to make all drug therapy decisions, including step therapy. Below is the Costco Health Solutions Preferred formulary list. Terms and Conditions. The committee also reviews these classes and reviews the entire formulary at least once a year. endstream endobj 1747 0 obj <>/Metadata 519 0 R/Outlines 865 0 R/Pages 1706 0 R/StructTreeRoot 1420 0 R/Type/Catalog>> endobj 1748 0 obj <>/ExtGState<>/Font<>/ProcSet[/PDF/Text/ImageC/ImageI]/XObject<>>>/Rotate 0/StructParents 0/Tabs/S/Type/Page>> endobj 1749 0 obj <>stream Looking at the latest statistics, costs are projected to rise, and by 2024, drug spending in commercial plans will grow on average 5% per year, up from 3.7% in 2021 through 2023. Pharmacy Directory, and Formulary on the Member Portal at. NOTE: Navitus uses the NPPES Database as a primary source to validate , Health4 hours ago WebClient Public Benefits, HealthJust Now WebNavitus - Logon This is where you can find information about your pharmacy benefit plan. Please contact Customer Care toll-free at the number listed on your pharmacy benefit member ID card for information regarding the dispensing of covered drugs while out of the country. 1746 0 obj <> endobj Comparison of Health & Pharmacy Benefits. Uniform Medical Plan's (UMP) 2023 Preferred Drug List (PDL) for Public Employees Benefits Board (PEBB) and School Employees Benefits Board (SEBB) members is now available. Gallup. Vanderbilt University is committed to principles of equal opportunity and affirmative action. Making it Right / Complaints and Grievances, Medicare Appointment of Representative Form. Plan formulary. Advanced Imaging and musculoskeletal utilization management programs, Summary of changes for Small and Individual Group members, Summary of changes for Large Group members. If your plan includes a benefit such as PreventiveRx or Exclusive Specialty, you will find your plan's applicable drug lists here. Health4 hours ago WebAt Navitus, we know that affordable prescription drugs can be life changingand lifesaving. Navitus believes that effective and efficient communication is the key to ensuring a strong working relationship with our participating . 0 1 By taking a closer look at your drug mix and formulary approach you can combat wasteful spend to lower costs. Accessed May 5, 2022. https://news.gallup.com/poll/4708/healthcare-system.aspx.3. In fact, Navitus client Net Promoter Score (NPS) increased to 76 from 72 in the prior year, a superstar rating4. hULU~C@H ]vjN8ju*!(,Zlqeq+I]p!Y4]LMd"E|WV[fF}>{] v A@Z>d5f xO UMR is a UnitedHealthcare company. Because behind every member ID is a real person and they deserve to be treated like one. Medicarerx.navitus.com. We're sorry, we don't offer OHP plans in . When selecting a medication, you and your doctor may wish to consult the Formulary to see if there is a Tier 1 option (lowest cost) that can treat your condition. According to our 2021 Annual Drug Trend Report, nearly half of all drug spend was driven by specialty medications, even though they represent less than 1% of utilization. If you have already registered, enter your User ID and Password. Customer Service Search our formulary to see medications by tier and coverage level. If you would like a Pharmacy Directory mailed to you, you may call the number above, or request one here. PreferredOne's pharmacy benefit is administered through ClearScript. All requests for member reimbursement should be directed to the following address: When selecting a medication, you and your doctor may wish to . ),Uj*H`4 @#q/ 2he^%V(Yy{i(_n\Mkb`y#x2Fi'bKIfg,$y 2K +Z4L3R5!_Fk*/24H.xXu. These reviews make sure the formulary isup-to-date andmeets member health needs. Welcome. All rights reserved. Still need help? The committee also reviews these classes and reviews the entire formulary at least once a year. There is an individual - a human being - behind every trend we monitor, every number we analyze. Your formulary (preferred drug list) is available inMember Portal. To find drugs covered by your plan: Go to the Navitus ETF Benefits website . There are three tiers in the rating: Tier 1 is the lowest cost medication; Tier 3 is the highest cost. lovastatin). Dental plans in Oregon provided by Oregon Dental Service, dba Delta Dental Plan of Oregon. This can be obtained from the pharmacy that you filled the Prescription. If questions regarding benefits arise, the summary of benefits and coverage document is the master resource. . This resource is meant to help you keep up-to-date with details about your benefit. 2022 Evidence of Coverage for Navitus MedicareRx (PDP) 1 . Navitus believes that effective and efficient communication is the key to ensuring a strong working relationship with our prescribers. below titled "How do I request an exception to the Navitus MedicareRx Formulary?" Drugs removed from the market. 24 hours a day, 7 days a week(closed Thanksgiving and Christmas Day). You can request the participating pharmacy located in the area where you will be traveling to request your current pharmacy to transfer your prescription order. The formulary is the list of drugs covered by Community Care. Individual medical plans in Alaska provided by Moda Assurance Company. They assess thedrugs based on the following: Effectiveness Cost 1. The machine-readable format below is displayed in accordance with CMS regulations and guidance. All rights reserved | Email: [emailprotected], Most affordable health insurance companies, Adventhealth fish memorial medical records. Thecommitteedecides which drugs toinclude and exclude from the formulary. I have read and acknowledge this and would like to proceed. The committee completes ongoing new and existing drug reviews. TTY users can dial 711. You can use this tool to check drug prices at pharmacies of your choice. The Texas Managed Medicaid STAR/CHIP/STAR Kidsformulary, including the Preferred Drug List and any clinical edits, is defined by the Texas Vendor Drug Program. Brand name drugs are listed in all upper case letters. How do I determine what my copayment will be for this drug? On Monday, March 21, 2022, the message below was sent to members of UC medical plans with pharmacy benefits administered by Navitus Health. We are on a mission to make a real difference in our customers' lives. Please see your Quartz Prescription Drug Benefit Rider or contact Quartz Customer Service at (800) 362-3310 to verify your coverage. Home - Consolidated Associations of Railroad Employees (CARE) The search field will populate a drop-down menu of available drugs that begin with those letters. 2022 Formulary List of covered drugs Please read: This document contains information about the drugs we cover in this plan This formulary was updated on 12/01/2022. All rights reserved. Also included is information regarding which drug products are subject to prior authorization and/or quantity limits and drugs that are part of the RxCents Tablet Splitting Program. Your satisfaction and health is our top priority. INTRODUCTIONThe rising cost of prescriptions is a growing issue in health care and a top concern for most Americans. If you need help finding a network provider, please call customer service: (855) 645-8448 (TTY 711). To learn more about Navitus, call 877.571.7500 or visit www.navitus.com. If you need a replacement card, please The Formulary helps you find lower-cost alternatives. The Prescriber Portal offers 24/7 access to plan specifications, formulary and prior authorization forms, everything you need to manage your business and provide your patients the best possible care. %PDF-1.7 % It includes prescription drugs that are established to be clinically sound and cost effective by a committee of prescribers and pharmacists. Please click on the link (s) , Health1 hours ago WebOngoing review of new and existing prescription drugs ensures the formulary is up-to-date, and meets the health needs of all patients. The good news is that, at Navitus, we apply our same passion for affordability to specialty. ]o*xh-VIg /;}\F#IY P_#R-L*!_dx^]K.^p,+x-X^X`Y^tSo=e*MA{YROq99O"/yk1Tf6@p.a.>On{2F"e`1 b, I{l:Xi1w Y Then answer the security question. The display of third-party trademarks and trade names on this site does not necessarily indicate any affiliation or endorsement of healthpoom.com. Vanderbilt, Vanderbilt University, V Oak Leaf Design, Star V Design and Anchor Down are trademarks of The Vanderbilt University, Form 1095-C available March 3 online at My VU Benefits, Report 2022 contributions to outside retirement plans by April 1, HR Employee Learning and Engagement offers peer-to-peer learning opportunities for managers and leaders, HR Employee Learning and Engagement seeks interest for December small group life and career design series, HR Employee Learning and Engagement: CliftonStrengths for VU Employees Nov. 15, First Report of Injury - Workers' Compensation, Site Development: Digital Strategies (Division of Communications). Call Navitus Customer Care at (855) 673-6504 and they can help you get the ID information, download the Navitus app, and also work with the pharmacist to get your prescription claim processed. Assumes a 50% rebate. Prime 4-Tier 2023. The formulary document does not list every covered medication. Drug formulary. The rising cost of prescriptions is a growing issue in health care and a top concern for most Americans. Navitus will also provide robust support to help you better understand and manage your prescription drug benefit, including: 24/7 customer care A pre-enrollment website (coming in October) with tools for finding participating pharmacies, checking drug prices at the pharmacy of your choice, and looking up drugs included in the formulary (the . January 2023 BCBSMN GenRx Formulary Updates. Select your health plan design. Im new to Navitus; do I need to change to a new pharmacy? The Formulary. For more information about which formulary you are on, log in to DeanConnect. 2019 Healthpoom.com. Effective July 1, 2022. If you have already registered, enter your User ID and Password. If you can't find an answer, please feel free to contact our We have exciting news to share. endstream endobj startxref Therapeutic classes are a group of similar drugs and have the same effect in the body. There is a Pharmacy Search tool, which can help you find pharmacies within a specific area. However, anticipated biosimilar launches in 2023 may offer some savings potential moving forward. If you need 2022 information about your prescription drug, call Washington State Rx Services (WSRxS) at 1-888-361-1611 (TRS: 711). All Time Your preferred pharmacy for filling the medication you take on an ongoing basis is the OptumRx Mail Service Pharmacy. Navitus MedicareRx will provide these OTC drugs at no cost to you. It is , Health5 hours ago Webhealth plan participants the choice of nearly 4,400 hospitals, 79,000 ancillary care facilities and more than 700,000 healthcare professionals nationwide, whether they seek care in , Health6 hours ago WebH8056_14_101R2 CMS APPROVED 7/31/2015 Updated 12/6/2017. If traveling for less than one month: A member can make a request for reimbursement by completing the Direct Member Claim Form(PDF). How do I request reimbursement for pharmacy claims? Hyperinflation Exclusions from 2019-2022. Check patient-specific eligibility and benefits on CignaforHCP. A PBM also negotiates discounts and rebates with drug manufacturers. Moda Health. Please contact the Customer Care toll free number listed on your pharmacy benefit member ID card or call Navitus Customer Care at 1-844-268-9789. 2022 . If your benefit plan meets the requirements of the Affordable Care Act. How do I request an exception to coverage or medication appeal information? Lumicera Health Services Powered by Navitus Innovative Specialty Pharmacy Solutions- Lumicera Health Services is defining the "new norm" in specialty pharmacy to optimize patient well-being through our core principles of transparency and stewardship.Here at Lumicera, our team members work in an environment that celebrates creativity and fosters diversity. Drug Coverage. By returning 100% of rebates and discounts received and deploying a lowest-net-cost philosophy, Navitus helps reduce costs and improve member health. Theformulary is also called apreferred drug list. Preventive drugs. There are three tiers in the rating: Tier 1 is the lowest cost medication; Tier 3 is the highest cost. We identify drugs with hyperinflated costs and quickly remove them from the formulary to deliver timely savings* $563M or $2.32 PMPM client savings January-July 2022 CVS Health, 2022. The committee decides what to add, remove, and change on the formulary. Drug Name Special Code Tier Category Alphabetical Index Last Updated 3/1/2023 GHC-SCW 3-Tier Complete Formulary Name. If you do not know the correct spelling, you can start your search by entering just the first few letters of the name. If you are new to Community Health Choice (HMO D-SNP) and are taking a non-formulary drug, you are eligible for a temporary supply . This is coupled with cost and cost-effectiveness data to determine which drugs hold an advantage over the other. This includes managing requests for proposals (RFP), and request for information (RFI) for network access with manufacturers. This plan, Navitus MedicareRx (PDP), is offered by Navitus Health Solutions and underwritten by Dean Health Insurance, Inc., A Federally-Qualified Medicare Contracting Prescription Drug Plan. Find a doctor, dentist, pharmacy or clinic. Please contact Customer Care toll-free at the number listed on your pharmacy benefit member ID card for questions about your pharmacy benefit. When you choose UMR, it becomes our job to help you get the most out of your pharmacy benefit. This site is subject to change in order to comply with state and federal law, including the Affordable Care Act (ACA) and related regulations, and connectivity with the federal Marketplace. Please click on the link(s) below to view the formulary documents. Aetna Better Health FIDA Plan is a managed care plan that contracts with both Medicare and the New York , Health1 hours ago WebVersion 2022-3 Page 4 of 31 4.1 ALLOWABLE NON -PRESCRIPTION DRUGS/OTC DRUGS Non-prescription/OTC drugs included in the therapeutic categories listed in the . GETTING MORE VALUE FROM SPECIALTY PHARMACY MANAGEMENTWith the skyrocketing cost of specialty medications, its a bigger slice of drug spend than ever before. Our new 2021 Annual Drug Trend Report demonstrates we helped clients improve health outcomes and cost savings for the over 8.5 million Americans we are proud to serve through our 100% pass-through approach and lowest-net-cost formulary. Public Opinion on Prescription Drugs and Their Prices. If unsure which Navitus documents apply to your patient, please contact Pharmacy Services at 888-361-1610. These efforts kept specialty trend to 4.3% for our clients, which is the lowest it has been in recent years.WHATS TO COME IN 2022 AND BEYONDThe 2021 Annual Drug Trend Report findings underscore that investing in a PBM partner that aligns with a clients goals is necessary to achieve desired cost savings and peace of mind that your members are receiving the best possible health care. See your Schedule of Benefits for more information. Past 24 Hours Most often, you will be able to continue to use your current pharmacy. One or more Benefit/Program Drug Lists may also apply to your plan. S9701_2022_SOM_SB_V01_M . January 2023 BCBSMN FlexRx Formulary Updates. What is Step Therapy? The formulary is updated each month and is available on the website at Medicarerx.navitus.com (for the member portal click on Members, then Login). Type. When you choose UMR, it becomes our job to help you get the most out of your pharmacy benefit. Accessed May 4, 2022. https://www.kff.org/health-costs/poll-finding/public-opinion-on-prescription-drugs-and-their-prices/.2. For Medicare plan information, please visit modahealth.com/plans/medicare. If the medication isnt working or your need is medically necessary, please ask your prescriber to contact Navitus. Pharmacy Guidance , Health1 hours ago WebNavitus Health Solutions is a pharmacy benefit manager. This means that even though a drug is listed on this formulary, it may not be covered by your specific benefit plan. All rights reserved. We update our online formulary on a regularly scheduled basis to include any changes that have occurred after the last update. If you click a merchant link and buy a product or service on their website, we may be paid a fee by the merchant. The Texas Managed Medicaid STAR/CHIP formulary, including the Preferred Drug List and any clinical edits, is defined by the Texas Vendor Drug Program. This is done in an evidence based manner by our Pharmacy and Therapeutics (P&T) Committee that reviews clinical trial data to assess the relevant evidence and determine any clinical or safety advantage. January 2023 BCBSTX Basic Annual Drug List Updates Providence Health Plan 1-800-423-9470 The coverage associated with each drug is noted on the formulary. Your responses, however, will be anonymous. The formulary does not specifically indicate the dollar amount members can expect to pay for each drug product. Here at Memorial Hermann Advantage we strive to provide our members with the most accurate Pharmacy Directories. Health5 hours ago The enclosed formulary is current as of 10/01/2022. NPS is measured from -100 to 100.5. Ongoing review of new and existing prescription drugs ensures the formulary is up-to-date, and meets the health needs of all patients. Pharmacy Formulary. 2016 United HealthCare Services, Inc. (mm/dd/yyyy) You will receive notice when necessary. Our mission is to improve member health and minimize their out-of-pocket costs. Managed care pharmacist with focus in Industry Relations & Contracting, Drug Information, Specialty Pharmacy, and Formulary Operations management. Every effort has been made to ensure this information is current and correct. Healthcare System. MEDICARERX(PDP) . We focus on addressing gaps in care within each members prescription journey and providing best-in-class client care while sustaining savings. Drugs listed in the formulary are arranged by drug class. Copyright document.write(new Date().getFullYear()); Moda Partners, Inc. All rights reserved. Standard Formulary. Health plans provided by Moda Health Plan, Inc. The Pharmacy Portal offers 24/7 access to plan specifications, formulary and prior authorization forms, everything you need to manage your business and provide your patients the best possible care. We've developed these drug formularies to help our members and your providers choose the appropriate drugs based on your needs, coverage plan and cost of each drug. This plan, Navitus MedicareRx (PDP), is offered by Navitus Health Solutions and underwritten by Dean Health Insurance, Inc., A Federally-Qualified Medicare Contracting Prescription Drug Plan. The formulary explains what prescription drugs are covered by the plan. We provide cost-effective prescription drug benefits for our clients and their members. The list must meet the requirements of Medicare and/or Medicaid. We are on a mission to make a real difference in our customers' lives. Tell us you're interested and we'll be in touch with details. eligibility in system, claims questions, request for replacement ID card, etc.)? your keyboard. Before you choose a plan, its important for you to understand a few things about how prescription benefits work with us. Accessibility information. The goal of the Costco Health Solutions formulary, also known as a preferred drug list is used to help members and prescribers to make the best medication decision in terms of safety, efficacy, cost effectiveness and overall value. Please select the state you live in, or the state where your employer is headquartered, so we can tailor your experience: You can return to your previous location in the site header. Box 999 Table of Contents . Appleton, WI 54912-0999. The Cigna Coverage Review Department is transitioning . Alignment healthcare access card balance, Pfizer retirement health benefits center, Most affordable health insurance companies, Womens health magazine customer service, Navitus health solutions formulary 2022, Adventhealth fish memorial medical records. Continued growth is expected of specialty drug utilization and spend, primarily due to targeted immunomodulators and dermatology medications. -5)A$E(4R"Z5QLXt7+`l3 /A6WN o -./gA)bONoo(G7=^r)o"5NY\spuIhth8*IRAb?dv_cxT%t8g9^/{9$`x;8Y*[-YqDT,]1O1:*y2#F[|$+CGQc~S*k&K"Ek?q%5x@pFqv&`f^a47-hVSi#R^2PVG)V8w9'ZO 9(R92#HpO6qM[f.zQa"NP)"6S.5}@#E"7$lfp|tv2:j,z{l@,[D7$O+IlkZv=Fz0 a! 1-800-813-2000 Kaiser Formulary. This formulary was updated on 10/01/2022. The UMR Formulary includes brand and generic medication approved by the FDA. The formulary, pharmacy network, and/or provider network may change at any time. D}H;Cq{'i^SvMHr6(+`STQ9/81oQhazG1=IV@kc4!-\V For individual and group plans that use the Navitus Network, search our formulary to see medications by tier and coverage level. Cook Children's Health Plan uses Navitus Health Solutions as their Pharmacy Benefit Manager (PBM). Have your pharmacy call Navitus to obtain your member information. Footer Oregon Health Authority This number could be higher or lower, but still costs more than the lowest-net-cost model drug. Formulary. ou can speak to a pharmacist who can answer your questions anytime, day or night. Explanation of benefits for prescription drug benefits. Smart consumers know a good deal when they see one, and will go for the $14.50 product. Because behind every member ID is a real person , Health1 hours ago WebThe Pharmacy Portal offers 24/7 access to plan specifications, formulary and prior authorization forms, everything you need to manage your business and provide your patients the best possible care. It shows thegeneric drugs in lower case letters (e.g. With home delivery, you may save with a month supply of your medication with free standard shipping. Now that you've had some interactions with us, we'd like to get your feedback on the overall experience. Cigna covers thousands of drug prescriptions, all intended to give your patients the best value. This resource is meant to help you keep up-to-date with details about your benefit. Recent topics have included: Express Scripts' 2022 formulary exclusion list, Amazon's pharmacy, generics in Part D, 340B research, zero-dollar copay, pass-through rebates, PBMs' spread pricing, Rite Aid's Bartell deal, healthcare pricing trends, the DSCSA, John Venn, and more. Step therapy is a formulary tool used to manage high-cost medications while improving health. The Non-Participating Pharmacy must still have a valid pharmacy ID (NPI) in order for the Plan to approve the paper claim. When a medication requires step therapy, you are encouraged to try a less costly, clinically equivalent drug first. If you are creating an account for an adult member of your family, that member must have given you permission to set up an account in his/her behalf. Medicare Plans. Each medication is rated according to its cost. Our survey will only take a few minutes, and your responses are, of course, confidential. For the most current list of covered medications or if you have questions: Call the number on your member ID card. If you haven't registered yet, click on the link for. At Navitus, we know that affordable prescription drugs can be life changingand lifesaving. Which formulary/drug list applies to your plan? January 2023 BCBSNE Formulary Updates. 2022, CVS Pharmacy is no longer participating with Navitus. A formulary is a list of brand and generic medications. Navitus Health Solutions. nt: Ex isting m embers wl not r c v a IDcard ach year. Traditional QR , Health7 hours ago WebNavitus Medicare Rx - How to Read Formulary The Drug Formulary The formulary is also called a preferred drug list. P.O. Drug utilization review is a program of quality assurance to determine the appropriate . Side-effects This will ensure you pay only the member out-of-pocket expense for your prescription. Vaccines covered at the pharmacy; Preferred diabetes supplies & insulins; Summary of changes for Small and Individual Group members; Summary of changes for Large Group members; If unsure which Navitus documents apply to your patient, please contact Pharmacy Services at 888-361-1610. Priority is put on current U.S. All-in, net-cost PMPM was calculated from Navitus commercial clients, including employers of all types (retail, manufacturing, government, school districts) and commercial health plans, and comprised of different and varied health populations.4.