2018 Preventive medications and your plan
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- Lucinda Osborne
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1 Managing your health with preventive medications Your pharmacy benefit plan includes special coverage for preventive medications. These drugs help protect against or manage a medical condition, such as: Preventing blood clots and reducing the risk of a stroke Preventing heart disease and reducing high blood pressure Preventing osteoporosis (a disease that leads to an increased risk of bone fracture) Your health is important. Taking preventive medications as directed by your health care provider can help you avoid serious illness and high health care costs.
2 Special coverage for preventive medications Drugs on your plan s list of preventive medications are not subject to a deductible. You ll pay your copayment/coinsurance or nothing at all, depending on your plan. So you can save money and get the medications you need to help you live a healthier life. Preventive medications are a subset of products included within your plan s formulary, or list of prescription drugs, which tells you what medications your plan covers. Please note that most medications on the Formulary are subject to a deductible. Preventive medications are an exception. To check the cost of any medication, refer to your benefit handbook or contact customer service at the toll-free member phone number on your benefit plan ID card. Potential savings with generic medications To get the most from your benefits, ask your doctor if a generic medication is right for you. Generics normally cost less than brand medications, and the Food and Drug Administration (FDA) requires them to be just as safe and effective. Quality drives our decisions Our committee of independent doctors and pharmacists meets regularly to review medications and consider how they should be covered by your pharmacy benefit plan. They also recommend which medications should be on your plan s list of preventive medications. A list of covered preventive medications begins on the next page. Medications are listed by therapeutic category. To help you tell generic and brand drugs apart, all generics start with a lowercase letter. For questions on injectable dose forms of preventive medications administered by your healthcare provider, please call the number on the back of your membership card for more information.
3 2018 Preventive medication list Expanded listing by therapeutic category ANTIHYPERGLYCEMIC Glyxambi Korlym ASTHMA AND COPD Accolate Anoro Ellipta Asmanex budesonide Combivent cromolyn sodium Dulera Gastrocrom ipratropium/albuterol montelukast nebulizers and inhaler assistive devices Proair HFA Pulmicort Qvar Respiratory Supplies Serevent Diskus Spiriva Symbicort Ventolin HFA zafirlukast Zyflo Cr BONE DISEASE AND FRACTURES Actonel alendronate Boniva Evista Fosamax Fosamax Plus D ibandronate raloxifene Reclast zoledronic acid BONE RESPORPTION INHIBITORS Didronel Etidronate Disodium Pamidronate Disodium Xgeva Zometa CHOLESTEROL LOWERING MEDICINES HMG-COA Reductase Inhibitors atorvastatin lovastatin Mevacor PravachoL pravastatin rosuvastatin Simvastatin Zocor Other Agents Advicor Antara fenofibrate ezetimibie fenofibric acid gemfibrozil Lopid niacin Niacor Niaspan Er omega-3-acid ethyl esters Simcor Tricor Trilipix vascepa CONTRACEPTIVES (Various) Apri Aviane Cyclesse Desogen Lo Loestrin Fe Lo/Ovral Loestrin Mircette Nordette Nuvaring
4 Ocella Ortho-Novum Seasonale Yasmin Zovia DIABETES Insulin Humalog, 50/50, 75/25 Humulin Lantus Lantus Solostar Levemir Non-insulin Actoplus Met Actos Amaryl Avandamet Avandaryl Avandia Byetta Diabeta Duetact Fortamet glimepiride glipizide and combinations Glucophage Glucovance Glucotrol glyburide and combinations Glynase Invokana Janumet Januvia metformin nateglinide pioglitazone and combinations Prandin repaglinide Starlix Symlin HEART DISEASE AND STROKE Blood Thinner Medicines Aggrenox Arixtra Aspirin, 81mg, 162mg or 325 mg Brilinta clopidogrel Coumadin dypyridamole Effient Enoxaparin Sodium Fondaparinux Lovenox Persantine Plavix Ticlid ticlopidine Warfarin Xarelto HIGH BLOOD PRESSURE Ace Inhibitors Accupril benazepril enalapril lisinopril Lotensin moexipril Prinivil quinapril Univasc Vasotec Zestril Ace Inhibitors/Diuretic Combinations Accuretic benazepril/hctz enalapril/hctz lisinopril/hctz Lotensin Hct moexipril/hctz quinapril/hctz Uniretic Vaseretic Zestoretic Angiotensin II Receptor Antagonists Atacand Avapro candesartan Cozaar irbesartan losartan olmesartan valsartan Angiotensin II Receptor Antagonists/Diuretic Combinations Atacand HCT Avalide candesartan/hctz Hyzaar irbesartan/hctz losartan/hctz olmesartan/hctz valsartan/hctz
5 Beta Blockers atenolol bisoprolol Bystolic Inderal LA Innopran XL metoprolol propranolol Tenormin Zebeta Beta Blockers/Diuretic Combinations atenolol/chlorthalidone bisoprolol/hctz Corzide Lopressor HCT metoprolol/hctz nadolol/bendroflumethiazide propranolol/hctz Tenoretic Ziac Calcium Channel Blockers Adalat CC amlodipine Calan Cardizem Cardizem la diltiazem nifedipine nisoldipine Procardia XL Sular Tiazac verapamil Verelan Diuretics chlorthalidone indapamide metolazone Zaroxolyn Other High Blood Pressure Medicine Combinations amlodipine/atorvastatin amlodipine/benazepril amlodipine/olmesartan amlodipine/olmesartan/ hydrochlorothiazide amlodipine/telmisartan Caduet Exforge Exforge Hct ezetimibe/simvastatin Lotrel Tarka Twynsta Diuretics And Combinations Aldactone amiloride Dyazide hydrochlorothiazide indapamide Maxzide metolazone spironolactone triamterene-hctz Zaroxolyn High Blood Pressure Medicines Miscellaneous aliskiren and combinations amlodipine/benazepril amlodipine/olmesartan amlodipine/olmesartan/ hydrochlorothiazide amlodipine/telmisartan amlodipine/valsartan amlodipine/valsartan/ hydrochlorothiazide Amturnide Azor Cardura carvedilol Catapres clonidine Clorpres Coreg Coreg CR doxazosin Exforge Exforge HCT hydralazine Lotrel Tekamlo Tekturna Tekturna HCT terazosin Tribenzor Twynsta
6 HEPATITIS C Copegus Pegasys Peg-Intron Rebetol Ribapak Ribavirin Sovaldi NASAL ANTI- INFLAMMATORY STEROIDS Budesonide Dymista Flunisolide mometasone Qnasl PSYCHOTHERAPEUTIC DRUGS Anti-Anxiety Alprazolam ER Alprazolam Diazepam Lorazepam Attention Deficit- Hyperactivity (ADHD) Adderall Amphetamine Salt Combo Dexmethylphenidate HCL Dexmethylphenidate HCL ER Dextroamphetamine Sulfate ER Dextroamphetamine- Amphet ER Focalin Focalin XR Intuniv Methylphenidate ER Methylphenidate HCL Methylphenidate HCL CD Methylphenidate LA Quillivant XR Ritalin Strattera Vyvanse Antipsychotics Abilify Clozapine Clozaril Geodon Haloperidol Olanzapine Quetiapine Fumarate Risperidone Bipolar disorder Lithium Carbonate Er Lithium Carbonate Lithobid Benzodiazepine Antagonists Flumazenil Romazicon Depression Amitriptyline HCL Brintellix Brisdelle Bupropion HCL Bupropion HCL SR Bupropion XL Citalopram HBR Desipramine HCL Doxepin HCL Duloxetine Escitalopram Oxalate Fluoxetine HCL Mirtazapine Nefazodone HCL Nortriptyline HCL Paroxetine HCL Sertraline HCL Venlafaxine HCL Venlafaxine HCL ER Viibryd Glucocorticoids Dexamethasone Methylprednisolone Orapred Odt Phosphate Prednisolone Prednisolone Sodium Prednisone Immunosuppressants Gengraf Imuran Neoral Prograf Ramapune Sandimmune Tacrolimus
7 Other Antidepressants Marplan Nardil Parnate Sedative Hypnotics armodafinil Eszopiclone Intermezzo Modafinil Temazepam Trazodone Hcl Zaleplon Zolpidem Tartrate Zolpidem Tartrate Er THYROID Armour Thyroid Levothyroxine Sodium Levoxyl Nature-Throid Synthroid
8 This list is intended as a reference and may not be all-inclusive. Brand or generic availability may not be current due to changes in the market. Use of generics may be required depending upon plan design. optumrx.com OptumRx specializes in the delivery, clinical management and affordability of prescription medications and consumer health products. We are an Optum company a leading provider of integrated health services. Learn more at optum.com. All Optum trademarks and logos are owned by Optum, Inc. All other trademarks are the property of their respective owners Optum, Inc. All rights reserved. ORX2523-CU_ Preventive Standard
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