Covered Expenses

Except as noted in "Expenses That Are Not Covered," the Plan covers the following drugs and supplies, with a prescription, at the levels shown in "Highlights of the Plan":

  • Federal legend drugs
  • State restricted drugs
  • Compound drugs (custom-made for an individual patient) – covered only when provided by EnvisionCompounding
  • Diabetic drugs, insulin, and supplies (approved products only)
  • Needles and syringes
  • Prenatal vitamins
  • Approved over-the-counter (nonprescription) drugs, covered only when prescribed and dispensed at an on-site Health Center, available at most Alliance Coal mines and offices

Coverage for some drugs is subject to prior authorization from the Plan, as noted with "Requires PA" on the Coverage Tiers (Formulary). To request prior authorization, call EnvisionRxOptions Customer Service toll-free at (800) 361-4542. Your physician will need to provide information to satisfy the prior-authorization requirements, and then the Plan will determine if reimbursement for the drug will be approved for your medical condition.

A six-month lifetime maximum benefit applies to Narcotic-Addiction Drugs.