Prominence Health Plan is finding ways to make infusion therapies more affordable to members and to employer groups. Alternative sites of care outside of hospitals are considered much more affordable, safer, and more convenient. Various clinical studies have shown similar effectiveness of the drug with less risk of hospital-acquired infections.
Beginning March 1, 2020, Prominence Health Plan will update the out-of-pocket cost for specific provider-administered oncology treatments for certain qualified employer groups. At this time, this change in reduced payment only impacts specific groups of health plan membership dependent upon group size and employer.
It is important to note that the oncology treatments affected by this change are administered by a provider and administered within a physician’s office or at a free-standing facility. This change does NOT apply or impact the prescription drug benefit. Please refer to the list below for the specific oncology infusions. Additionally, members may be billed for other services while in the provider setting, but the infusion therapy itself will be at no cost.
Prominence Health Plan Members
To determine if there has been a change to your medical benefits, please refer to your health plan Summary of Benefits document within the secure member portal. You can also call the Prominence Health Plan Customer Service team at 800-863-7515 and we can advise if there has been a change.