As previously communicated by CVS Caremark, effective May 20, 2016, the generic for Crestor became available in the marketplace; however, select Medicare Part D Plans (listed below) continued to cover the brand name Crestor at the Preferred Brand Tier and the generic, rosuvastatin calcium was NOT covered. Effective August 26, 2016, both brand Crestor and generic, rosuvastatin calcium will be payable on the formularies for the plans listed below.

Dear Valued Provider,

Effective August 5, 2016, Blue Cross and Blue Shield of North Carolina changed Crestor from Tier 1 or 2 to Tier 3 or 4 drug depending on the Covered Person’s benefits. This change is due to multiple new generic versions of Crestor (rosuvastatin calcium) being available on the market. If a Participating Pharmacy submits a claim for Crestor for a Covered Person, the claim will process at a tier 3 or 4 copayment compared to a Tier 1 or 2 copayment for rosuvastatin calcium.

For questions about coverage of Crestor or the generic products, please refer patients to the Customer Service number on the back of their Blue Cross ID card.

If you have any questions about claims processing, please call the Prime Contact Center at 800.821.4795. Sincerely,

Pharmacy Network Management

Prime Therapeutics LLC

* Coverage of Crestor is dependent on the Covered Persons’ benefit plan

Dear Valued Provider, Effective August 5, 2016, Blue Cross and Blue Shield of Kansas (BCBSKS) will be changing Crestor to a Tier 3 covered drug*. This change is due to more generic versions of Crestor (rosuvastatin calcium) being available on the market. If a Participating Pharmacy submits a claim for Crestor for a Covered Person, the claim will process at a Tier 3 copayment compared to Tier 1 copayment for rosuvastatin calcium.

August 5, 2016

Dear Valued Provider,

Effective August 5, 2016, Florida Blue will no longer be advantaging Crestor brand. This change is due to more generic versions of Crestor (rosuvastatin calcium) being available on the market. If a Participating Pharmacy submits a claim for Crestor for a Covered Person, the claim will process at a brand copayment compared to a generic copayment for rosuvastatin calcium. Rosuvastatin calcium will no longer require a prior authorization.

For questions about coverage of Crestor or the generic products, please refer Covered Persons to the Customer Service number on the back of their Florida Blue ID card.

If you have any questions about claims processing, please call the Prime Contact Center at 800.821.4795.

Sincerely,

Pharmacy Network Management

Prime Therapeutics, LLC