EmblemHealth Split Fill Program

The Pharmacy “split fill” program is intended to limit waste of unused, expensive specialty medications that have a higher potential for discontinuation during the first few weeks of treatment due to medication intolerance and adverse effects which often require additional physician monitoring.

To help eliminate unnecessary member out-of-pocket cost, and prescription waste, for the first two months of treatment members will receive a maximum 15 day supply. The member’s copayment amount will be adjusted to reflect the 15 day supply of medication being dispensed.

The “split fill” program includes the following medications:

• Afinitor • Tarceva
• Bosulif • Targretin
• Gleevec • Tecfidera
• Hycamtin • Tykerb
• Imatinib Mesylate • Votrient
• Olysio • Xeljanz
• Sprycel • Zelboraf
• Sutent • Zolinza
• Tafinlar • Zytiga

The program impacts members in the Medicaid, Commercial, and Health Insurance Exchange Management (HIX) plans.

A full month supply of medication will be dispensed after completion of the “split fill” program.

*As of 2/8/2016 Harvoni, Sovaldi and Viekira are no longer part of the “split fill” program.*