2019 Preventive medications and your plan
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1 2019 Preventive medications and your plan Managing your health with preventive medications Your pharmacy benefit plan includes special coverage for generic preventive medications. These medications 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 told by your healthcare provider can help you avoid serious illness and high healthcare costs.
2 Special coverage for generic preventive medications The drugs on your plan s preventive medications list do not have a deductible. This means you ll pay your copayment/coinsurance or nothing at all, depending on your plan. It can save you money and get the medications you need to help you live a healthier life. Your plan only offers this special coverage for generic drugs on the preventive medications list. Preventive medications are a group of products in your plan s formulary which tells you what medications your plan covers. Please note that most medications on the formulary have a deductible, but generic preventive medications do not. To check the cost of any medication, see your benefit handbook or contact customer service at the member phone number on your ID card. Quality drives our decisions A group of doctors and pharmacists meets often to review medications and suggest coverage under pharmacy benefit plans. They also recommend which medications should be on plan s generic preventive medications list. A list of generic preventive medications begins on the next page. Medications are listed by therapeutic category. Your specific plan may not cover all of the drugs. Please see your plan s formulary for coverage details. Oral and self-injectable Specialty medications are labled with an SP note and may have limitations based on your plan benefit. For questions on injectable dose forms of preventive medications driven by your healthcare provider, please call the member phone number on your ID card.
3 Generic medications by therapeutic category ANTIPSYCHOTICS aripiprazole chlorpromazine clozapine fluphenazine haloperidol loxapine molindone olanzapine olanzapine / fluoxetine paliperidone ER perphenazine prochlorperazine quetiapine quetiapine ER risperidone thioridazine thiothixene trifluoperazine ziprasidone ASTHMA AND COPD albuterol neb / syp / tab albuterol ER budesonide suspension cromolyn nebulizer solution ipratropium inhalation solution ipratropium / albuterol isoproterenol levalbuterol neb metaproterenol montelukast terbutaline theochron CR theophylline theophylline CR / ER zafirlukast zileuton ER CANCER anastrozole exemestane SP letrozole SP raloxifene tamoxifen CARDIOVASCULAR/ HEART DISEASE Anti-Anginal Agents isosorbide dinitrate isosorbide dinitrate ER isosorbide mononitrate isosorbide mononitrate ER minitran nitroglycerin nitro-time petn Anticoagulants ASA / dipyridamole cilostazol clopidogrel dipyridamole enoxaparin SP fondaparinux SP heparin jantoven prasugrel warfarin Cardiac Glycosides digitek digox digoxin High blood pressure acebutolol afeditab CR amiloride amiloride / hctz amlodipine amlodipine / atorvastatin amlodipine / benazepril amlodipine / olmesartan amlodipine / valsartan atenol / chlorthalidone atenolol benazepril benazepril / hctz betaxolol bisoprolol bisoprolol / hctz bumetanide candesartan candesartan / hctz captopril captopril / hctz cartia xt carvedilol chlorothiazide chlorthalidone clonidine dilt-xr diltiazem diltiazem CD diltiazem ER doxazosin enalapril enalapril / hctz eplerenone eprosartan SP
4 ethacrynic acid ezide felodipine ER fosinopril fosinopril / hctz furosemide guanfacine hydralazine hydrochlorothiazide indapamide irbesartan irbesartan / hctz isradipine labetalol lisinopril lisinopril / hctz losartan losartan / hctz matzim LA methyclothiazide methyldopa methyldopa / hctz metolazone metoprolol metoprolol ER metoprolol / hctz minoxidil (tablet) moexipril moexipril / hctz nadolol nadolol / bendroflumethiazide nicardipine nifediac CC nifedical XL nifedipine nifedipine ER nimodipine nisoldipine nisoldipine ER olmesartan olmesartan / amlo / hctz olmesartan / hctz perindopril phenozybenzamine pindolol prazosin hcl propranolol propranolol ER propranolol / hctz quinapril quinapril / hctz ramipril sotalol sotalol AF spironolactone spironolactone / hctz taztia XT telmisartan telmisartan / amlodipine telmisartan / hctz terazosin timolol (tablet) torsemide trandolapril trandolapril / verapamil triamterene / hctz valsartan valsartan / hctz verapamil verapamil ER / SR High cholesterol atorvastatin cholestyramine cholestyramine lite colesevelam colestipol ezetimibe ezetimibe / simvastatin fenofibrate fenofibric fenofibric DR fluvastatin gemfibrozil lovastatin niacin ER (Rx) niacor omega-3-acid (Rx) pravastatin prevalite rosuvastatin simvastatin triklo CONTRACEPTIVES generic contraceptive patch generic emergency contraceptives generic injectable contraceptive generic oral contraceptives DIABETES Non-insulin acarbose chlorpropamide glimepiride glipizide / metformin glipizide glipizide ER / XL glyburide glyburide / metformin glyburide micronized metformin metformin ER metformin ER (mod) metformin ER (osm) miglitol nateglinide pioglitazone pioglitazone / glimepride pioglitazone / metformin repaglinide tolazamide tolbutamide ESTROGENS amabelz covaryx covaryx HS eemt eemt HS est estrogen mtest SP
5 est estrogen mtest HS estra / noreth estrad val estradiol estrog / mtest estropipate fyavolv jevantique jinteli lopreeza mimvey mimvey lo noreth / ethin GASTROINTESTINAL-ULCER DRUGS cimetidine esomeprazole mag DR famotidine lanso / amox / clarith lansoprazole misoprostol nizatidine omeppi omepra / bicar omeprazole pantoprazole rabeprazole ranitidine sucralfate HIV/AIDS abacavir SP abacavir / lamivudine SP abacavir / lamivudine / zidovudine SP atazanavir SP didanosine SP efavirenz SP fosamprenavir SP lamivudine SP lamivudine / zidovudine SP lopinavir / ritonavir sol SP nevirapine SP nevirapine ER SP ritonavir SP stavudine SP tenofovir SP zidovudine SP OSTEOPOROSIS alendronate calcitonin spray etidronate ibandronate raloxifene risedronate SMOKING DETERRENTS buproban bupropion nicotine gum nicotine lozenge nicotine patch TRANSPLANT azathioprine cyclosporine SP cyclosporine modified SP gengraf SP mycophenolate SP mycophenolic DR SP sirolimus SP tacrolimus cap SP VITAMINS & HEMATINICS Pediatric vitamins with fluoride Generic Products Prenatal multivitamins with iron and folic acid Generic Products SP
6 SP This list should be used as a reference and may not include all medications. Brand or generic availability may not be current due to changes in the market. 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. ORX2523A_ B Preventive Standard Generics
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