MCS Farmaflex

Administre sus medicamentos con prudencia.

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Como asegurado de MCS Life, podrá conocer su historial de medicamentos y ver el detalle de sus copagos. Solo tiene que registrarse, de manera segura, en la aplicación Mi MCS para recibir este beneficio exclusivo. Comuníquese con nuestro Centro de Llamadas de Servicio al Cliente para verificar la información de acceso, de ser necesario.

Beneficios de farmacia

El beneficio de farmacia es un componente integral de todos los servicios de cuidado de la salud, pues le permite comprar sus medicamentos recetados en farmacias participantes. Y como siempre, MCS Life da la milla extra en su camino hacia la salud, ofreciéndole además varias iniciativas y programas que complementan su beneficio de farmacia:

Medicamentos Fuera del Recetario (OTC)

Los OTC son medicamentos fuera del recetario aprobados por la Administración de Alimentos y Medicamentos (FDA, por sus siglas en inglés). Para conocer si su cubierta incluye el beneficio de medicamentos OTC refiérase a su póliza o certificado de beneficios.

Medicamentos Fuera del Recetario (OTC) - 2026

Programa de Medicamentos por Correo

Su beneficio de farmacia también le permite obtener medicamentos recetados a través del correo. Este programa le brinda una manera cómoda y económica de solicitar un suplido de hasta 90 días en medicamentos de mantenimiento.

Condiciones que requieren medicamentos de mantenimiento:

Alta presión

Colesterol

Arritmias

Diabetes

Asma

Tiroides

Ventajas

Cinco pasos para comenzar:

Pídale a su médico una receta para un suplido de medicamentos de mantenimiento de hasta 90 días, más las repeticiones.
Complete la Solicitud de Medicamentos por Correo.
Incluya las recetas escritas por su médico.
Incluya la cantidad de su copago o coaseguro o su información de tarjeta de crédito.
Incluya los documentos mencionados en los puntos 2, 3 y 4 en el sobre predirigido y prefranqueado y envíelos por correo. Sus medicamentos ahora están en camino.

Preguntas frecuentes sobre nuestro
Programa de Medicamentos por Correo.

Solicitud de Medicamentos por Correo

Bioequivalent Medications

The Food and Drug Administration (FDA) regulates the production of all bioequivalent medications. Many companies that produce brand medications are the same as those that produce bioequivalent medications.

When you choose bioequivalent medications, you help to keep the costs of your pharmacy coverage at a lower level.

They are safe and effective!

They contain the same active ingredients as brand medications.
Are identical in their presentation form (tablets, capsules), strength, dosage forms, and means of administration. Nonetheless, they can vary in form and color.

Specialty Medications Program

The Pharmaceutical Care Management Association (PCMA) defines specialty medications as medications that possess multiple of the following attributes:

High monthly cost
Not available at most chain or independent pharmacies. There are even drugs that have limited distribution.
- Limited Distribution: The manufacturing house only gives you access to the purchase of medicines at a limited number of pharmacies.
Prescribed for a person with a chronic or complex illness, for example:
- rheumatoid arthritis
- multiple sclerosis
- crohn's disease
- ulcerative colitis
- cancer
- hepatitis C
- HIV
- psoriasis
- among others
Treats indications of rare diseases
- A rare disease affects fewer than 200,000 Americans. There are approximately 7,000 rare diseases in the world.
It is an oral, injectable, inhalable or infusion medicine
Has unique storage or shipping requirements, such as refrigeration
Requires education, adherence, and additional patient support beyond traditional dispensing activities.

Most specialty drugs require a preauthorization process (evaluation of your health plan) due to their high cost and usage specifications. Specialty medications may be covered by your Pharmacy Benefit or Medical Component, which will depend on the management that such medication requires:

Pharmacy Benefit	Medical Component
Oral medications Auto-injectable medications: Patient can self-administer the medication	Intravenous medications Medications that must or may administered by a healthcare professional

Requirements

MCS Life requires preauthorization for most specialty medications. This means that minimal information is required to evaluate a request for a specialty medication. For example:

Prescription that includes all the requirements according to the Puerto Rico Pharmacy Law.

It must also include the specific diagnosis for which the drug is prescribed. Ex. ICD10 - K51.0 Ulcerative (chronic) pancolitis without complications.

Additional information: History of previous treatments, laboratories, progress notes from your doctor, imaging tests, among others.

Biosimilars medications

Biosimilars are safe and effective drugs for the treatment of many chronic or complex diseases. These biologic drugs are approved by the Food and Drug Administration (FDA) that are comparable to another drug - the original drug. FDA approval is based on review of data, studies and tests, product quality, and monitoring of its safety and efficacy.

To better understand the concept of ‘biosimilars,’ we will first need to understand the FDA's fundamental terms.

Biological Product- Reference Drug	Biosimilars
They can be made with sugars, proteins, live cells, tissues or a combination of them. They are made from natural and living sources such as animal cells, plants, and microorganisms like bacteria and yeast.	A biosimilar is a medication that is very similar to a biologic drug already approved by the FDA - the original biologic (also known as the reference product). Furthermore, the biosimilars have no clinically significant differences from the reference product. This means that you can expect the same safety and efficacy with a biosimilar throughout a treatment as with the reference product.

What is an interchangeable biosimilar?

Drug companies do extra optional testing to get Food and Drug Administration (FDA) approval for interchangeability. Once approved, pharmacists can substitute the interchangeable biosimilar for the original drug when dispensing, without the need for a new prescription.

Examples:

Biological Product- Reference Drug	Biosimilars
Neulasta	Fulphila Ziextenzo
Neupogen	Nivestym Zarxio
Remicade	Avsola ® Renflexis ® Inflectra ®
Avastin	Mvasi ® Zirabev ®
Herceptin	Kajinti ® Trazimera ® Herzuma ®
Rituxan	Riabni ® Ruxience ® Truxima ®

Benefits

Drug Delivery Program for 90 days at local pharmacy

This program allows you to order an 84 to 90-day supply of certain maintenance drugs through participating pharmacies within your local pharmacy network.

If you are already stable on your treatment, ask your doctor for a 90-day supply prescription plus one (1) refill of your maintenance medications.

Step Therapy Program

This program encourages the use of first-line medications to treat your medical condition before using any other second-line medications for treatment.

First-line drugs are considered those treatment options that are supported by national clinical guidelines and standards of medical practice as alternatives to be used in initial therapy. Second-line drugs are treatment options, as are first-line drugs, but guidelines place them as alternatives to be used after first-line drugs have been used.

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