Reducing your out-of-pocket costs for the medicine you need Chronic Medicine List

Transcription

1 Quality health plans & benefits Healthier living Financial well-being Intelligent solutions Reducing your out-of-pocket costs for the medicine you need Chronic Medicine List G (8/16)

2 Receive medicine for chronic conditions without first having to meet your deductible. If you have certain conditions such as high blood pressure, high cholesterol, diabetes, asthma or depression, you ll be interested in a special feature that can help you manage the cost of the medicine you need. We understand how important it is to take the medicine prescribed by your doctor, and the Aetna chronic medications feature makes it easier for you to do that. Health benefits and health insurance plans are offered, administered and/or underwritten by Aetna Health Inc., Aetna Health Insurance Company of New York, Aetna Health Insurance Company and/or Aetna Life Insurance Company (Aetna). In Florida, by Aetna Health Inc. and/or Aetna Life Insurance Company. In Maryland, by Aetna Health Inc., 151 Farmington Avenue, Hartford, CT Each insurer has sole financial responsibility for its own products.

3 For chronic conditions, forget the HRA deductible just pay your copay or coinsurance when buying these medications. Category Generic medicine Brand-name medicine Antihypertensive medicine (high blood pressure) Angiotensin-converting enzyme (ACE) inhibitors/ combinations benazepril benazepril/ hydrochlorothiazide (HCTZ) captopril captopril/hctz enalapril enalapril/hctz fosinopril fosinopril/hctz lisinopril lisinopril/hctz moexipril moexipril/hctz perindopril quinapril quinapril/hctz ramipril trandolapril trandolapril/verapamil ACCUPRIL ACCURETIC ACEON ALTACE EPANED LOTENSIN LOTENSIN HCT MAVIK PRINIVIL PRINZIDE QBRELIS TARKA UNIRETIC UNIVASC VASERETIC VASOTEC ZESTORETIC ZESTRIL Angiotensin II receptor antagonists/renin inhibitor combinations amlodipine/valsartan amlodipine/valsartan/ HCTZ candesartan candesartan/hctz eprosartan irbesartan irbesartan/hctz losartan losartan/hctz telmisartan telmisartan/hctz valsartan valsartan/hctz ATACAND ATACAND HCT AVALIDE AVAPRO AZOR BENICAR BENICAR HCT COZAAR DIOVAN DIOVAN HCT EDARBI EDARBYCLOR EXFORGE EXFORGE HCT HYZAAR MICARDIS MICARDIS HCT TEKTURNA TEKTURNA HCT TRIBENZOR TWYNSTA VALTURNA

4 Category Generic medicine Brand-name medicine Alpha-adrenergic/ beta-adrenergic blockers acebutolol atenolol atenolol/chlorthalidone betaxolol bisoprolol bisoprolol/hctz carvedilol doxazosin labetalol metoprolol metoprolol/hctz metoprolol ER nadolol nadolol/ bendroflumethiazide prazosin propranolol propranolol ER propranolol/hctz pindolol sorine sotalol sotalol AF terazosin timolol BETAPACE BETAPACE AF BYSTOLIC BYVALSON CARDURA COREG COREG CR CORGARD CORZIDE DUTOPROL INDERAL LA INNOPRAN XL KERLONE LEVATOL LOPRESSOR LOPRESSOR HCT MINIPRESS SECTRAL TENORMIN TENORETIC TOPROL XL ZEBETA ZIAC Calcium channel blockers/ miscellaneous combinations afeditab CR amlodipine amlodipine/benazepril cartia XT diltiazem diltiazem CD/ER/XR dilt-xr ethacrynic acid felodipine ER isradapine matzim LA nicardipine nifedical XL nifedipine nifedipine ER nimodipine nisoldipine nisoldipine ER taztia XT telmisartan/amlodipine verapamil verapamil ER ADALAT CC CALAN CALAN SR CARDENE SR CARDIZEM CARDIZEM CD/LA COVERA-HS LOTREL NORVASC NYMALIZE PRESTALIA PROCARDIA PROCARDIA XL SULAR TIAZAC VERELAN PM Diuretics acetazolamide acetazolamide ER amiloride amiloride/hctz bumetanide chlorothiazide chlorthalidone eplerenone ethacrynic acid furosemide HCTZ indapamide methazolamide methyclothiazide metolazone spironolactone spironolactone/hctz torsemide triamterene/hctz ALDACTAZIDE ALDACTONE BUMEX DEMADEX DIAMOX DIURIL DYAZIDE DYRENIUM EDECRIN INSPRA INTROL KEVEYIS LASIX MAXZIDE MICROZIDE NEPTAZANE ZAROXOLYN Antihypertensive miscellaneous clonidine guanfacine hydralazine methyldopa methyldopa/hctz minoxidil CATAPRES CLORPRES DEMSER DIBENZYLINE NEXICLON XR TENEX VECAMYL Antihyperlipidemia medicine (high cholesterol) HMG-CoA reductase inhibitors (statins)/ miscellaneous amlodipine besylate/ atorvastatin atorvastatin fluvastatin fluvastatin ER lovastatin pravastatin rosuvastatin simvastatin ALTOPREV CADUET CRESTOR LESCOL XL LIPITOR LIVALO MEVACOR PRAVACHOL VYTORIN ZETIA ZOCOR Miscellaneous Antihyperlipidemics none JUXTAPID KYNAMRO PRALUENT REPATHA

5 Category Generic medicine Brand-name medicine Bile acid sequestrants/ fibric acids/ miscellaneous other antihyperlipidemics cholestyramin colestipol fenofibrate fenofibric fenofibric DR gemfibrozil omega-3 acid niacin ER prevalite ANTARA COLESTID FENOGLIDE FIBRICOR LIPOFEN LOFIBRA LOPID LOVAZA NIACOR NIASPAN QUESTRAN QUESTRAN LITE TRICOR TRILIPIX VASCEPA WELCHOL Anti-angina isosorbide dinitrate isosorbide dinitrate ER isosorbide mononitrate isosorbide mononitrate ER minitran nitroglycerin nitroglycerin ER nitroglycerin lingual nitroglycerin transdermal nitro-time DILATRATE-SR IMDUR ISORDIL TITRADOSE NITRO-BID NITRO-DUR NITROLINGUAL pumpspray NITROMIST NITRONAL NITROSTAT RANEXA Cardiac glycosides/ miscellaneous other digoxin LANOXIN Anti-asthmatics (asthma)/copd albuterol albuterol ER aminophylline budesonide cromolyn sodium ipratropium bromide ipratropium bromide/ albuterol levalbuterol HCl metaproterenol sulfate montelukast sodium terbutaline sulfate theochron theophylline theophylline ER zafirlukast ACCOLATE ADVAIR DISKUS ADVAIR HFA AEROSPAN ALVESCO ANORO ELLIPTA ARCAPTA NEOHALER ARNUITY ELLIPTA ASMANEX HFA ASMANEX TWISTHALER ATROVENT HFA BEVESPI AEROSPHERE BREO ELLIPTA BROVANA COMBIVENT RESPIMAT DALIRESP DULERA ELIXOPHYLLIN FLOVENT DISKUS FLOVENT HFA INCRUSE ELLIPTA ISUPREL LUFYLLIN MAXAIR AUTOHALER PERFOROMIST PROAIR HFA PROAIR RESPICLICK PROVENTIL HFA PULMICORT FLEXHALER PULMICORT QVAR SEEBRI NEOHALER SEREVENT DISKUS SINGULAIR SPIRIVA HANDIHALER STIOLTO RESPIMAT STRIVERDI RESPIMAT SYMBICORT THEO-24 TUDORZA PRESSAIR VENTOLIN HFA VOSPIRE ER XOPENEX XOPENEX CONC XOPENEX HFA ZYFLO ZYFLO CR Antidiabetic medicine Insulins none AFREZZA APIDRA APIDRA SOLOSTAR HUMALOG products HUMULIN products LANTUS LANTUS SOLOSTAR LEVEMIR LEVEMIR FLEXPEN LEVEMIR FLEXTOUCH NOVOLIN products NOVOLOG products RELION products TOUJEO SOLOSTAR TRESIBA

6 Category Generic medicine Brand-name medicine Antidiabetic orals/ injectables acarbose alogliptin alogliptin/metformin alogliptin/pioglitazone chlorpropamide glimepiride glipizide glipizide ER glipizide XL glipizide/metformin HCl glyburide glyburide micronized glyburide/metformin HCl metformin HCl metformin HCl ER miglitol nateglinide pioglitazone HCl pioglitazone HCl/ metformin pioglitazone HCl/ glimepiride repaglinide repaglinide/metformin tolazamide tolbutamide ACTOPLUS MET ACTOPLUS MET XR ACTOS AMARYL AVANDARYL AVANDIA BYDUREON BYETTA CYCLOSET DUETACT FARXIGA FORTAMET GLUCAGEN HYPOKIT GLUCAGON EMERGENCY KIT GLUCOPHAGE GLUCOPHAGE XR GLUCOTROL GLUCOTROL XL GLUCOVANCE GLUMETZA GLYNASE GLYSET GLYXAMBI INVOKAMET INVOKANA JANUMET JANUMET XR JANUVIA JARDIANCE JENTADUETO JENTADUETO XR KAZANO KOMBIGLYZE XR KORLYM NESINA ONGLYZA OSENI PRANDIN PRECOSE PROGLYCEM RIOMET STARLIX SYMLIN SYMLINPEN SYNJARDY TANZEUM TRADJENTA TRULICITY VICTOZA XIGDUO XR Diabetic supplies (diabetes) insulin syringes any generic lancets any generic pen needles any generic BD insulin syringes BD lancets BD pen needles FREESTYLE glucose test strips FREESTYLE INSULINX glucose test strips FREESTYLE LITE glucose test strips ONETOUCH VERIO glucose test strips ONETOUCH ULTRA glucose test strips PRECISION XTRA glucose test strips PRECISION XTRA ketone test strips ALL OTHER BRANDS glucose test strips ALL OTHER BRANDS insulin syringes ALL OTHER BRANDS lancets ALL OTHER BRANDS pen needles

7 Category Generic medicine Brand-name medicine Antidepressants amitriptyline HCl amoxapine bupropion HCl bupropion HCl ER bupropion HCl XL citalopram clomipramine HCl desipramine HCl desvenlafaxine ER doxepin HCl duloxetine HCl escitalopram fluoxetine DR fluoxetine HCl fluvoxamine fluvoxamine ER imipramine HCl imipramine maprotiline HCl mirtazapine mirtazapine ODT nefazodone HCl nortriptyline HCl paroxetine HCl paroxetine HCl ER phenelzine sulfate protriptyline HCl sertraline HCl tranylcypromine trazodone HCl venlafaxine HCl venlafaxine HCl ER ANAFRANIL APLENZIN BRINTELLIX CELEXA CYMBALTA EFFEXOR XR ELAVIL EMSAM FETZIMA FORFIVO XL IRENKA KHEDEZLA LEXAPRO MARPLAN NARDIL NORPRAMIN PAMELOR PARNATE PAXIL PAXIL-CR PEXEVA PRISTIQ PROZAC PROZAC WEEKLY REMERON REMERON SOLTAB SURMONTIL TOFRANIL VIIBRYD VIVACTIL WELLBUTRIN WELLBUTRIN SR WELLBUTRIN XL ZOLOFT Antipsychotics aripiprazole chlorpromazine HCl clozapine clozapine ODT compro fluphenazine HCl haloperidol lithium carbonate lithium carbonate ER loxapine olanzapine olanzapine/fluoxetine olanzapine ODT paliperidone ER perphenazine prochlorperazine quetiapine risperidone risperidone M-Tab risperidone ODT thioridazine HCl thiothixene trifluoperazine HCl ziprasidone HCl ABILIFY ADASUVE CLOZARIL EQUETRO FANAPT FAZACLO GEODON INVEGA LATUDA LITHOBID NUPLAZID REXULTI RISPERDAL RISPERDAL M-TAB SAPHRIS SEROQUEL SEROQUEL XR SYMBYAX VERSACLOZ VRAYLAR ZYPREXA ZYPREXA ZYDIS

8 Please remember that this is not a complete list of medications covered under your plan. Because there are thousands of medications included in your pharmacy benefit, we only list the most common ones. Certain drugs such as those for smoking cessation or vitamins may not be covered by your particular pharmacy plan. Diabetic supplies may be covered under your medical plan. If you have any questions about your pharmacy benefits, please visit and log in to your member website. If you don t have access to our website, call the toll-free number on your member ID card. To check coverage and copay information for a specific medicine, visit and log in to your member website. For more details, please call the toll-free number on your member ID card. Aetna Pharmacy Management refers to an internal business unit of Aetna Health Management, LLC. This is not an inclusive list. Products that are not represented on this list may be subject to plan-specific copayment or coinsurance. Void where prohibited by law. Void in the State of CT. Specific prescription benefits plan design may not cover certain categories or may be subject to additional charges or restrictions, regardless of their appearance in this document. Aetna may receive rebates, discounts and service fees from pharmaceutical manufacturers for certain listed products. Your privacy is important to us. Our employees are trained regarding the appropriate way to handle your private health information. Information is believed to be accurate as of the production date; however, it is subject to change. For questions, please call the toll-free number on your member ID card Aetna Inc G (8/16)