Within Best Plan Medication Prescribed For Time Frame Available
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1 This list is provided as a courtesy to assist Settlers Life s appointed representatives with field underwriting. We will work with our Medical Director to keep this list as current as possible, but it may, at times, not be completely up-to-date. This edition current as of July Since some medications are prescribed for multiple conditions, please question your clients to determine why they have been prescribed a particular medication. Please include this information in the remarks section of the application to expedite processing and reduce the need for additional phone calls to obtain information. As always, plan availability is subject to the answers to health questions, any additional medical information received, and our underwriting guidelines. Abacavir AIDS/HIV/ARC Ever Decline Abatacept Rheumatoid Arthritis Abiraterone Cancer Abraxane Cancer Acamprosate Drug/Alcohol Abuse Acarbose Diabetes Aclidinium COPD, Actoplus Met Diabetes Actos Diabetes Adcetris Cancer Adefovir Hepatitis Dipivoxil Adriamycin Cancer Adrucil Cancer Afinitor Cancer Agenerase AIDS/HIV/ARC Ever Decline U-126 1
2 Aggrenox Angina, CAD, Aldesleukin Cancer Alemtuzumab Cancer Alimta Cancer Alkaban Cancer Altretamine Cancer Amaryl Diabetes Amiodarone Angina, CAD, Amnesteem Cancer Amprenavir AIDS/HIV/ARC Ever Decline Anakinra Rheumatoid Arthritis Antabuse Drug/Alcohol Abuse Apidra Diabetes 2- II/Bronze/ Apixaban Angina, CAD, Apokyn Parkinson s Disease Apomorphine Parkinson s Disease Aptivus AIDS/HIV/ARC Ever Decline Aranesp Chronic Kidney Disease/Cancer Arcapta COPD, Arformoterol COPD, Aricept Alzheimer s/ Ever Decline Arranon Cancer Artane Parkinson s Disease Arzerra Cancer Asenapine Asparaginase Cancer Atamet Parkinson s Disease Atazanavir AIDS/HIV/ARC Ever Decline Atripla AIDS/HIV/ARC Ever Decline Avandamet Diabetes Avandaryl Diabetes Avandia Diabetes Avastin Cancer Avonex Hepatitis Axitinib Cancer Azasan Organ Transplant Ever Bronze/ Azathioprine Organ Transplant Ever Bronze/ Azilect Parkinson s Disease Baraclude Hepatitis Basiliximab Organ Transplant Ever Bronze/ Belatacept Organ Transplant Ever Bronze/ Belomycin Cancer Bendamustine Cancer 2 3
3 Betapace Angina, CAD, Betaseron Hepatitis Bevacizumab Cancer Bexarotene Cancer Bexxar Cancer BiCNU Cancer Blenoxane Cancer Boceprefir Hepatitis Bortezomib Cancer Brentuximab Cancer Vedotin Brovana COPD, Buprenorphine Drug/Alcohol Abuse Busulfan Cancer Busulfex Cancer Byetta Diabetes Campath Cancer Campral Drug/Alcohol Abuse Camptosar Cancer Capecitabine Cancer Caprelsa Cancer Carbidopa Parkinson s Disease Carboplatin Cancer Cardoxin Angina, CAD, Carfilzomib Cancer Carmustine Cancer CellCept Organ Transplant Ever Bronze/ Cerubidine Cancer Cetuximab Cancer Chlorambucil Cancer Chlorpromazine Chlorpropamide Diabetes Cisplatin Cancer Cladribine Cancer Claravis Cancer Clopidogrel Angina, CAD, Clozapine Clozaril Cognex Alzheimer s/ Ever Decline Combivir AIDS/HIV/ARC Ever Decline Complera AIDS/HIV/ARC Ever Decline Comtan Parkinson s Disease Copegus Hepatitis 4 5
4 6 Cordarone Angina, CAD, Cosmegen Cancer Coumadin Angina, CAD, Crixivan AIDS/HIV/ARC Ever Decline Crizotinib Cancer Cyclophosphamide Cancer Cyclosporine Organ Transplant Ever Bronze/ Cytarabine Cancer Cytosar Cancer Cytoxan Cancer Dacarbazine Cancer Dactinomycin Cancer Darunavir AIDS/HIV/ARC Ever Decline Dasatinib Cancer Daunorubicin Cancer DaunoXome Cancer Delavirdine AIDS/HIV/ARC Ever Decline DiaBeta Diabetes Diabinese Diabetes Dicumarol Angina, CAD, Didanosine AIDS/HIV/ARC Ever Decline Digitek Angina, CAD, Digoxin Angina, CAD, Dilatrate Angina, CAD, Dipyridamole Angina, CAD, Disopyramide Angina, CAD, Disulfiram Drug/Alcohol Abuse Docefrez Cancer Docetaxel Cancer Dolophine Drug/Alcohol Abuse Donepezil Alzheimer s/ Ever Decline Doxil Cancer Doxorubicin Cancer Droxia Cancer 7
5 8 DTIC Dome Cancer Duetact Diabetes Edurant AIDS/HIV/ARC Ever Decline Efavirenz AIDS/HIV/ARC Ever Decline Efudex Cancer Eldepryl Parkinson s Disease Eliquis Angina, CAD, Ellence Cancer Eloxatin Cancer Elspar Cancer Emcyt Cancer Emtricitabine AIDS/HIV/ARC Ever Decline Emtriva AIDS/HIV/ARC Ever Decline Enfuvirtide AIDS/HIV/ARC Ever Decline Enoxaparin Angina, CAD, Entacapone Parkinson s Disease Entecavir Hepatitis Epirubicin Cancer Epivir AIDS/HIV/ARC Ever Decline Epoetin Alfa AIDS/HIV/ARC Ever Decline Epogen AIDS/HIV/ARC Ever Decline Epzicom AIDS/HIV/ARC Ever Decline Erbitux Cancer Eribulin Cancer Erlotinib Cancer Erwinaze Cancer Eskalith Estramustine Cancer Etopophos Cancer Etoposide Cancer Etravirine AIDS/HIV/ARC Ever Decline Everolimus Organ Transplant Ever Bronze/ Exelon Alzheimer s/ Ever Decline Exenatide Diabetes Exubera Diabetes 2- II/Bronze/ Fanapt Fareston Cancer Floxuridine Cancer Fludara Cancer Fludarabine Cancer Fluoroplex Cancer Fluorouracil Cancer Fluphenazine Folotyn Cancer Foradil COPD, Formoterol COPD, Fortamet Diabetes 9
6 Fosamprenavir AIDS/HIV/ARC Ever Decline FUDR Cancer Fuzeon AIDS/HIV/ARC Ever Decline Galantamine Alzheimer s/ Ever Decline Gefitinib Cancer Gemcitabine Cancer Gemtuzumab Cancer Gemzar Cancer Gengraf Organ Transplant Ever Bronze/ Geodon Gliadel Cancer Glimepiride Diabetes Glipizide Diabetes Glucophage Diabetes Glucotrol Diabetes Glucovance Diabetes Glumetza Diabetes Glyburide Diabetes Glynase Diabetes Glyset Diabetes Halaven Cancer Haldol Haloperidol Hepsera Hepatitis Herceptin Cancer Hexalen Cancer Humalog Diabetes 2- II/Bronze/ Humulin Diabetes 2- II/Bronze/ Hycamtin Cancer Hydrea Cancer Hydroxyurea Cancer Ibritumomab Cancer Tiuxetan Idamycin Cancer Idarubicin Cancer Ifex Cancer Ifosfamide Cancer Iloperidone Imdur Angina, CAD, Imuran Organ Transplant Ever Bronze/ Incivek Hepatitis Indacaterol COPD, Indinavir AIDS/HIV/ARC Ever Decline Infergen Hepatitis Inlyta Cancer Insulin Diabetes 2- II/Bronze/ Insulin Aspart Diabetes 2- II/Bronze/ 10 11
7 Insulin Detemir Diabetes 2- II/Bronze/ Insulin Glargine Diabetes 2- II/Bronze/ Insulin Glulisine Diabetes 2- II/Bronze/ Insulin Inhalation Diabetes 2- II/Bronze/ Insulin Lispro Diabetes 2- II/Bronze/ Intelence AIDS/HIV/ARC Ever Decline Interferon Alfa 2 Hepatitis Interferon Alfa 2a Hepatitis Interferon Alfa 2b Hepatitis Interferon Hepatitis Alfacon 1 Interferon Beta Hepatitis 1a Interferon Beta Hepatitis 1b Intron Hepatitis Invega Invirase AIDS/HIV/ARC Ever Decline Iressa Cancer Isentress AIDS/HIV/ARC Ever Decline Ismo Angina, CAD, Isoditrate Isordil Isosorbide Isosorbide Dinitrate Angina, CAD, Angina, CAD, Angina, CAD, Angina, CAD, Isotretinoin Cancer Ixabepilone Cancer Ixempra Cancer Jantoven Angina, CAD, Janumet Diabetes Januvia Diabetes Jentadueto Diabetes Kaletra AIDS/HIV/ARC Ever Decline Kemadrin Parkinson s Disease Kidrolase Cancer 12 13
8 Kineret Rheumatoid Arthritis Kombiglyze Diabetes Kyprolis Cancer Lamivudine AIDS/HIV/ARC Ever Decline Lanoxicaps Angina, CAD, Lanoxin Angina, CAD, Lantus Diabetes 2- II/Bronze/ Lapatinib Cancer Largactil Latuda Leukeran Cancer Leustatin Cancer Levemir Diabetes 2- II/Bronze/ Levodopa Parkinson s Disease Lexiva AIDS/HIV/ARC Ever Decline Linagliptin Diabetes Liraglutide Diabetes Lithium Lithobid 14 Lodosyn Parkinson s Disease Lopinavir AIDS/HIV/ARC Ever Decline Lovenox Angina, CAD, Lurasidone Maraviroc AIDS/HIV/ARC Ever Decline Mellaril Memantine Alzheimer s/ Ever Decline Mercaptopurine Cancer Mesoridazine Metaglip Diabetes Metformin Diabetes Methadone Drug/Alcohol Abuse Methadose Drug/Alcohol Abuse Micronase Diabetes Miglitol Diabetes Mitomycin Cancer Mlindone Moban Monoket Angina, CAD, 15
9 Mutamycin Cancer Mycophenolate Organ Transplant Ever Bronze/ Myfortic Organ Transplant Ever Bronze/ Myleran Cancer Mylocel Cancer Mylotarg Cancer Naltrexone Drug/Alcohol Abuse Namenda Alzheimer s/ Ever Decline Nateglinide Diabetes Navane Navelbine Cancer Nelarabine Cancer N e lfinav ir AIDS/HIV/ARC Ever Decline Neoral Organ Transplant Ever Bronze/ Neosar Cancer Neulasta Cancer Nevirapine AIDS/HIV/ARC Ever Decline Nexavar Cancer Nilotinib Cancer Nipent Cancer Norpace Angina, CAD, Norvir AIDS/HIV/ARC Ever Decline Novolin Diabetes 2- II/Bronze/ Novolog Diabetes 2- II/Bronze/ NPH Diabetes 2- II/Bronze/ Nulojix Organ Transplant Ever Bronze/ Ofatumumab Cancer Olanzapine Oncaspar Cancer Oncovin Cancer Onglyza Diabetes Onxol Cancer Orencia Rheumatoid Arthritis Orinase Diabetes Oxaliplatin Cancer Pacerone Angina, CAD, Paclitaxel Cancer Paliperidone Panitumumab Cancer Paraplatin Cancer Parcopa Parkinson s Disease Pazopanib Cancer Hydrochloride PEG Intron Hepatitis Pegaspargase Cancer Pegasys Hepatitis 16 17
10 Peginterferon Hepatitis alfa2a Peginterferon Hepatitis alfa2b Pemetrexed Cancer Pentostatin Cancer Permitil Permole Angina, CAD, Perphenazine Pharmorubicin Cancer Pioglitazone Diabetes Platinol Cancer Plavix Angina, CAD, Pradimet Diabetes Pralatrexate Cancer Pramlintide Diabetes Prandimet Diabetes Prandin Diabetes Precose Diabetes Prezista AIDS/HIV/ARC Ever Decline Procrit AIDS/HIV/ARC Ever Decline Procrit Chronic Kidney Disease/Cancer Procyclidine Parkinson s Disease Prograf Organ Transplant Ever Bronze/ Proleukin Cancer Prolixin Provenge Cancer Purinethol Cancer Quetiapine Raltegravir AIDS/HIV/ARC Ever Decline Ranexa Angina, CAD, Rapamune Organ Transplant Ever Bronze/ Rasagiline Parkinson s Disease Razadyne Alzheimer s/ Ever Decline Rebif Hepatitis Reminyl Alzheimer s/ Ever Decline Repaglinide Diabetes Rescriptor AIDS/HIV/ARC Ever Decline Retrovir AIDS/HIV/ARC Ever Decline Revetol Hepatitis ReVia Drug/Alcohol Abuse Reyataz AIDS/HIV/ARC Ever Decline Ribavirin Hepatitis 18 19
11 Rilpivirine AIDS/HIV/ARC Ever Decline Riomet Diabetes Risperdal Risperidone Ritonavir AIDS/HIV/ARC Ever Decline Rituxan Cancer Rituximab Cancer Rivaroxaban Angina, CAD, Rivastigmine Alzheimer s/ Ever Decline Roferon Hepatitis Rosiglitazone Diabetes Rubex Cancer Salmeterol COPD, Sandimmune Organ Transplant Ever Bronze/ Saphris Saquinavir AIDS/HIV/ARC Ever Decline Saxagliptin Diabetes Selegiline Parkinson s Disease Selzentry AIDS/HIV/ARC Ever Decline Serenace Seretil 20 Serevent COPD, Seroquel Simulect Organ Transplant Ever Bronze/ Sinemet Parkinson s Disease Sipuleucel T Cancer Sirolimus Organ Transplant Ever Bronze/ Sitagliptin Diabetes Sorafenib Cancer Tosylate Sorine Angina, CAD, Sotalol Angina, CAD, Sotret Cancer Spiriva COPD, Sprycel Cancer Stalevo Parkinson s Disease Starlix Diabetes Stavudine AIDS/HIV/ARC Ever Decline Stelazine Streptozocin Cancer Suboxone Drug/Alcohol Abuse 21
12 Subutex Drug/Alcohol Abuse Sunitinib Cancer Sustiva AIDS/HIV/ARC Ever Decline Sutent Cancer Symlin Diabetes Tacrine Alzheimer s/ Ever Decline Tacrolimus Organ Transplant Ever Bronze/ Tarceva Cancer Targretin Cancer Tasigna Cancer Tasmar Parkinson s Disease Taxol Cancer Taxotere Cancer Telaprevir Hepatitis Telbivudine Hepatitis Temsirolimus Cancer Teniposide Cancer Tenofovir AIDS/HIV/ARC Ever Decline Thalidomide Cancer Thalomid Cancer Thioguanine Cancer Thioplex Cancer Thiotepa Cancer Thiothixene Thorazine Tiotropium COPD, 22 Tipranavir AIDS/HIV/ARC Ever Decline Tolazamide Diabetes Tolbutamide Diabetes Tolcapone Parkinson s Disease Tolinase Diabetes Toposar Cancer Topotecan Cancer Toremifene Cancer Torisel Cancer Tositumomab Cancer Tradjenta Diabetes Trastuzumab Cancer Treanda Cancer Tremin Parkinson s Disease Tretinoin Cancer Trifluoperazine Trihexyphenidyl Parkinson s Disease Trilafon Trizvir AIDS/HIV/ARC Ever Decline Truvada AIDS/HIV/ARC Ever Decline Tudorza COPD, Tykerb Cancer Tyzeka Hepatitis Vandetanib Cancer Vectibix Cancer Velban Cancer Velcade Cancer 23
13 Vemurafenib Cancer Vepesid Cancer Vesanoid Cancer Victoza Diabetes Victrelis Hepatitis Videx AIDS/HIV/ARC Ever Decline Vinblastine Cancer Vincasar Cancer Vincrex Cancer Vincristine Cancer Vinorelbine Cancer Tartrate Viracept AIDS/HIV/ARC Ever Decline Viramune AIDS/HIV/ARC Ever Decline Viread AIDS/HIV/ARC Ever Decline Vivitrol Drug/Alcohol Abuse Vorinostat Cancer Votrient Cancer Vumon Cancer Warfarin Angina, CAD, Xalkori Cancer Xarelto Angina, CAD, Xeloda Cancer Zanosar Cancer Zelapar Parkinson s Disease Zelboraf Cancer Zerit AIDS/HIV/ARC Ever Decline Zevalin Cancer Ziagen AIDS/HIV/ARC Ever Decline Zidovudine AIDS/HIV/ARC Ever Decline Ziprasidone Zolinza Cancer Zortress Organ Transplant Ever Bronze/ Zyprexa Zytiga Cancer 24 25
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