P
Mar 1, 2019

Pharmacy medication update

Effective April 1, 2019, coverage of Radicava will change from the specialty pharmacy benefit to the medical benefit.

ACA eligible list update - products removed (This was sent to 1,371 members.)
AMETHIA
JUNEL FE 24
OCELLA
AMETHIA LO
KAITLIB FE
OGESTREL
ARANELLE
LARIN 1.5/30
ORTHO MICRONOR
ASHLYNA
LARIN 24 FE
ORTHO TRI-CYCLEN
BALZIVA
LAYOLIS FE
ORTHO TRI-CYCLEN LO
BLISOVI 24 FE
LEVONOR AND ETHINYL ESTRA
RIVELSA
BLISOVI FE 1/20
LEVONORL/ETHINYL ESTRA
SAFYRAL
CAMRESE
LORYNA
SYEDA
CAMRESE LO
MELODETTA 24 FE
TILIA FE
DAYSEE
MIBELAS 24 FE
TRI-LEGEST FE
DROSPIR/ETHINYL ESTRAL
MY WAY
VESTURA
DROSPIR/ETHINYL ESTRA/LEVOMEF
NECON 1/50-28
VYFEMLA
ETHYNODIOL DIA/ETHINYL ESTRAL
NIKKI
ZARAH
GIANVI
NORETHIN & ETHINYL ESTRA FE