Pharmacy benefits

Important Pharmacy Network Update

The pharmacies in our network are changing. You’ll have to pay the full cost of your medicine if you use a pharmacy not in our network. This change will happen September 1, 2020.

It’s important to make sure your covered prescriptions are paid for by Aetna Better Health of Virginia. Always fill your prescriptions at a network pharmacy. There are pharmacies included in your plan. Network pharmacies include:

  • Any CVS Pharmacy® (including those inside Target® stores)
  • Most local neighborhood pharmacies
  • Many hospital pharmacies

It’s best to always get your medicine at a network pharmacy. If you are filling prescriptions at a pharmacy that will no longer be in the network, you will soon get a letter. The letter will tell you how to: 

  • Find a new pharmacy.
  • Move your current prescriptions to a different pharmacy 

You do not have to pay for covered prescriptions if you fill at a network pharmacy. You can view our Provider Directory here for a list of network pharmacies. You can also contact Member Services. For Medallion 4.0/FAMIS, call 1-800-279-1878 (TTY: 711). For CCC Plus, call 1-855-652-8249 (TTY: 711).

Getting the prescription drugs you need is an important part of your health care. We want to make it as convenient for you as possible. Learn more about your pharmacy benefits by clicking on the + in the expandable boxes below.

If you need medicine, your provider will choose a drug from our list of formulary drugs.

CCC Plus (nondual beneficiaries) and Medallion/FAMIS 4.0 Formulary

Dual-eligible Formulary

*Applies only to members who have Medicare coverage.

  • Your provider will write you a prescription. Ask your provider to make sure that the medicine is on our formulary list.
  • Take your prescription to a pharmacy that’s in our network.
  • Show your Aetna Better Health of Virginia member ID card at the pharmacy.

Check the list of network pharmacies and look for one in your area. If you need help, just call Member Services:

Medallion/FAMIS – Member Services

1-800-279-1878 (TTY 711)
24 hours a day, 7 days a week

CCC Plus – Member Services

1-855-652-8249 (TTY 711)
24 hours a day, 7 days a week

They’ll be glad to help you find a network pharmacy near you.

Always remember to fill your prescription at a network pharmacy. Your prescriptions won’t be covered at other pharmacies.

To prevent extra costs, check that your medicines are on the preferred drug list. This is called the formulary.

January 2020 CCC Plus (nondual beneficiaries) and Medallion 4.0/FAMIS Formulary

CCC Plus (nondual beneficiaries) and Medallion/FAMIS 4.0 Formulary

Dual-eligible formulary

*Applies only to members who have Medicare coverage.

January 2020 CCC Plus (nondual beneficiaries) and Medallion 4.0/FAMIS Formulary

If you have questions, just call Member Services:

Medallion/FAMIS – Member Services

1-800-279-1878 (TTY 711)
24 hours a day, 7 days a week

CCC Plus – Member Services

1-855-652-8249 (TTY 711)
24 hours a day, 7 days a week

Have a list of your prescriptions ready when you call. Ask us to look up your medicines to see if they’re on the list. 

You now have the ability to search for drugs using our new Formulary Search Tool.

CCC Plus and Medallion/FAMIS 4.0 Formulary Search Tool

Searches can be performed by drug name or by drug class. The tool will provide formulary status, generic alternatives and if there are any clinical edits (Prior Authorization, Quantity Limits, Age Limits etc.).

If your medicine is not on the formulary, there are some things you can do.

  • Ask your provider for a similar drug that is on the list.
  • Ask your provider to seek "prior authorization" (pre-approval) from Aetna Better Health of Virginia to cover this medicine. Your provider knows how to do this.

For certain kinds of drugs, you can use the plan’s mail-order services. Generally, the drugs available through mail order are drugs that you take regularly for a chronic or long-term medical condition. The drugs that are available through the CVS Caremark mail-order service are marked with “Drug eligible for 90 day supply fill for FAMIS 4.0 and CCC plus members only.” under the Prescriber Note section on the searchable formulary.

Our plan’s mail-order service allows you to order up to a 90-day supply for FAMIS 4.0 or CCC plus members.

Download the Prescription Drug Mail-order Form EnglishSpanish

To get order forms or get more information about filling your prescriptions by mail, call our Member Services at:

FAMIS 4.0 members: 1-800-279-1878 (TTY: 711) 24 hours a day, 7 days a week.

CCC Plus members: 1-855-652-8249 (TTY: 711) 24 hours a day, 7 days a week.

You can also request a mail order form by registering online with CVS Caremark. Once registered, you will be able to order refills, renew your prescription and check the status of your order.

Ask your doctor to write a new prescription(s) for up to the maximum mail order day supply. Please be advised that our mail order pharmacy will call you to obtain consent before shipping or delivering any prescriptions you do not personally initiate.

Fill out the order form completely, including your member ID#, your doctor's name, medications you are taking and any allergies, illnesses or medical conditions you may have.

Mail the order form and the prescription(s) to:

CVS Caremark
PO BOX 2110
Pittsburgh, PA 15230-2110

Generally, it takes CVS Caremark up to 21 days to process your order and ship it to you. If your mail order is delayed 21 days or more, the pharmacy should contact you. After 21 days, if you haven’t received your order, just call CVS Caremark Customer Care at 1-855-271-6603  (TTY: 1-800-231-4403). They’ll send you a replacement. You will receive your order quickly. Calls to this number are free.

Aetna Better Health also covers certain over-the-counter drugs, if they are on our formulary. Some are covered, under certain rules. If the rules for that drug are met, Aetna Better Health will cover the drug. Like other drugs, over-the-counter drugs must have a prescription from a provider for them to be covered.

You can look to see if your over-the-counter medicines are on our formulary. You can also check with Member Services:

Medallion/FAMIS – Member Services

1-800-279-1878 (TTY 711)
24 hours a day, 7 days a week

CCC Plus – Member Services

1-855-652-8249 (TTY 711)
24 hours a day, 7 days a week

When you call, have a list of your over-the-counter medicines ready. Ask the representative to look up your medicines to see if they’re on the list.

Your medicine bottle label says how many refills you can have. If your provider hasn’t ordered refills, and you think you need one, you must call him or her at least five days before your medicine runs out. When you call, ask your provider about getting a refill. He or she may want to see you first.

October 2020

Additions:

  • Ciprofloxacin-Dexamethasone Otic Susp 0.3-0.1%
  • Efavirenz-Lamivudine-Tenofovir Df Tab 400-300-300 Mg
  • Efavirenz-Lamivudine-Tenofovir Df Tab 600-300-300 Mg
  • Vancomycin Hcl Iv Soln 1250 Mg/250ml (Base Equivalent)    
  • Vancomycin Hcl Iv Soln 1750 Mg/350ml (Base Equivalent)    
  • Vancomycin Hcl Iv Soln 750 Mg/150ml (Base Equivalent)      

Removals:

  • Ciprodex Otic Susp 0.3-0.1%
  • Symfi Lo Df Tab 400-300-300mg
  • Symfi Df Tab 600-300-300mg

September 2020

Additions:

  • Abiraterone Tab 250mg (Prior Authorization)
  • Alecensa Cap 150mg (Prior Authorization)
  • Austedo Tab 12mg (Prior Authorization)
  • Austedo Tab 6mg (Prior Authorization)
  • Austedo Tab 9mg (Prior Authorization)
  • Bexarotene Cap 75mg (Prior Authorization)
  • Caprelsa Tab 100mg (Prior Authorization)
  • Caprelsa Tab 300mg (Prior Authorization)
  • Cinacalcet Tab 30mg (Prior Authorization)
  • Cinacalcet Tab 60mg (Prior Authorization)
  • Cinacalcet Tab 90mg (Prior Authorization)
  • Cyclophosph Cap 25mg
  • Cyclophosph Cap 50mg
  • Erivedge Cap 150mg (Prior Authorization)
  • Gilotrif Tab 20mg (Prior Authorization)
  • Gilotrif Tab 30mg (Prior Authorization)
  • Gilotrif Tab 40mg (Prior Authorization)
  • Jakafi Tab 10mg (Prior Authorization)
  • Jakafi Tab 15mg (Prior Authorization)
  • Jakafi Tab 20mg (Prior Authorization)
  • Jakafi Tab 25mg (Prior Authorization)
  • Jakafi Tab 5mg (Prior Authorization)
  • Kalydeco Pak 25mg (Prior Authorization)
  • Kalydeco Pak 50mg (Prior Authorization)
  • Kalydeco Pak 75mg (Prior Authorization)
  • Kalydeco Tab 150mg (Prior Authorization)
  • Lenvima Cap 10 Mg (Prior Authorization)
  • Lenvima Cap 12mg (Prior Authorization)
  • Lenvima Cap 14 Mg (Prior Authorization)
  • Lenvima Cap 18 Mg (Prior Authorization)
  • Lenvima Cap 20 Mg (Prior Authorization)
  • Lenvima Cap 24 Mg (Prior Authorization)
  • Lenvima Cap 4mg (Prior Authorization)
  • Lenvima Cap 8 Mg (Prior Authorization)
  • Linezolid Tab 600mg (Prior Authorization)
  • Mekinist Tab 0.5mg (Prior Authorization)
  • Mekinist Tab 2mg (Prior Authorization)
  • Ofev Cap 100mg (Prior Authorization)
  • Ofev Cap 150mg (Prior Authorization)
  • Omeprazole Tab 20mg Dr
  • Repatha Inj 140mg/Ml (Prior Authorization)
  • Repatha Push Inj 420/3.5 (Prior Authorization)
  • Repatha Sure Inj 140mg/Ml (Prior Authorization)
  • Rydapt Cap 25mg (Prior Authorization)
  • Soliris Inj 10mg/Ml (Prior Authorization)
  • Symdeko Tab 100-150 (Prior Authorization)
  • Symdeko Tab 50-75mg (Prior Authorization)
  • Tafinlar Cap 50mg (Prior Authorization)
  • Tafinlar Cap 75mg (Prior Authorization)
  • Venclexta Tab 100mg (Prior Authorization)
  • Venclexta Tab 10mg (Prior Authorization)
  • Venclexta Tab 50mg (Prior Authorization)
  • Venclexta Tab Start Pk (Prior Authorization)
  • Xolair Inj 150mg/Ml (Prior Authorization)
  • Xolair Inj 75/0.5 (Prior Authorization)
  • Xolair Sol 150mg (Prior Authorization)
  • Zykadia Cap 150mg (Prior Authorization)

Removals:

  • Prilosec OTC Tab 20mg DR

Other Updates:

  • No updates

August 2020

Additions:

  • Diclofenac Sodium Soln 1.5% (Step Therapy, Quantity Level Limit)
  • Ibrance Cap 100mg (Prior Authorization, Quantity Level Limit)
  • Ibrance Cap 75mg (Prior Authorization, Quantity Level Limit)
  • Ibrance Tab 100mg (Prior Authorization, Quantity Level Limit)
  • Ibrance Tab 125mg (Prior Authorization, Quantity Level Limit)
  • Ibrance Tab 75mg (Prior Authorization, Quantity Level Limit)
  • Ibrance Cap 125mg (Prior Authorization, Quantity Level Limit)
  • Lynparza Tab 10 (Prior Authorization, Quantity Level Limit)
  • Lynparza Tab 15 (Prior Authorization, Quantity Level Limit)
  • Symtuza Tab (Prior Authorization)
  • Testosterone Gel 1.62% (Prior Authorization, Quantity Level Limit)
  • Testosterone Td Soln 30 Mg/Act (Prior Authorization, Quantity Level Limit)

Removals:

  • Aftera Tab 1.5mg
  • Amlodipine Besylate-Atorvastatin Calcium Tab 10-10 Mg
  • Amlodipine Besylate-Atorvastatin Calcium Tab 10-20 Mg
  • Amlodipine Besylate-Atorvastatin Calcium Tab 10-40 Mg
  • Amlodipine Besylate-Atorvastatin Calcium Tab 10-80 Mg
  • Amlodipine Besylate-Atorvastatin Calcium Tab 2.5-10 Mg
  • Amlodipine Besylate-Atorvastatin Calcium Tab 2.5-20 Mg
  • Amlodipine Besylate-Atorvastatin Calcium Tab 2.5-40 Mg
  • Amlodipine Besylate-Atorvastatin Calcium Tab 5-10 Mg
  • Amlodipine Besylate-Atorvastatin Calcium Tab 5-20 Mg
  • Amlodipine Besylate-Atorvastatin Calcium Tab 5-40 Mg
  • Amlodipine Besylate-Atorvastatin Calcium Tab 5-80 Mg
  • Arformoterol Tartrate Soln Nebu 15 Mcg/2ml (Base Equiv)
  • Cimduo 300-300
  • Ec-Naproxen Tab 375mg
  • Econtra Ez Tab 1.5mg
  • Econtra Os Tab 1.5mg
  • Estradiol Td Patch Twice Weekly 0.025 Mg/24hr
  • Estradiol Td Patch Twice Weekly 0.0375 Mg/24hr
  • Estradiol Td Patch Twice Weekly 0.05 Mg/24hr
  • Estradiol Td Patch Twice Weekly 0.075 Mg/24hr
  • Estradiol Td Patch Twice Weekly 0.1 Mg/24hr
  • Estradiol Vg Vtb 10mcg
  • Fluocinolone Acetonide Solution 0.01%
  • Fluorouracil Cream 0.5%
  • Levonorgestr Tab 1.5mg
  • Mesalamine Tab Delayed Release 1.2 Gm
  • Mesalamine Tab Delayed Release 800 Mg
  • My Choice Tab 1.5mg
  • My Way Tab 1.5mg
  • Naproxen Sod Tab 550mg
  • Naproxen Sodium Tab 275 Mg
  • New Day Tab 1.5mg
  • Nimodipine Cap 30 Mg
  • Olanzapine-Fluoxetine Hcl Cap 12-25 Mg
  • Olanzapine-Fluoxetine Hcl Cap 12-50 Mg
  • Olanzapine-Fluoxetine Hcl Cap 3-25 Mg
  • Olanzapine-Fluoxetine Hcl Cap 6-25 Mg
  • Olanzapine-Fluoxetine Hcl Cap 6-50 Mg
  • Opcicon Tab 1.5mg
  • Plan B Tab 1.5mg
  • React Tab 1.5mg
  • Take Action Tab 1.5mg
  • Targretin Gel 1%
  • Tolmetin Sodium Cap 400
  • Tolmetin Sodium Tab 200
  • Tolmetin Sodium Tab 600
  • Zolmitraptan Odt 2.5 Mg Tab
  • Zolmitriptan 2.5 Mg
  • Zolmitriptan 5 Mg Tablet
  • Zolmitriptan Odt 5 Mg Tab

Other Updates:

  • Auryxia (Step Therapy)
  • Betamethasone Dipropionate Augmented Cream 0.05% (Quantity Level Limit)
  • Betamethasone Dipropionate Cream 0.05% (Quantity Level Limit)
  • Betamethasone Dipropionate Lotion 0.05% (Quantity Level Limit)
  • Butenafine Hcl Cream 1% (Quantity Level Limit)
  • Carbamide Peroxide 6.5% Otic Soln (Quantity Level Limit)
  • Ciclopirox Olamine Cream 0.77% (Quantity Level Limit)
  • Ciclopirox Olamine Susp 0.77% (Quantity Level Limit)
  • Ciclopirox Shampoo 1% (Quantity Level Limit)
  • Clindamycin Phosphate Gel 1% (Quantity Level Limit)
  • Clindamycin Phosphate Lotion 1% (Quantity Level Limit)
  • Clindamycin Phosphate Soln 1% (Quantity Level Limit)
  • Erythromycin Gel 2% (Quantity Level Limit)
  • Erythromycin Pads 2% (Quantity Level Limit)
  • Flunisolide Nasal Soln 25 Mcg/Act (0.025%) (Step Therapy)
  • Fluocinonide Cream 0.05% (Quantity Level Limit)
  • Fluvastatin Sodium Cap 20 Mg (Step Therapy)
  • Fluvastatin Sodium Cap 40 Mg (Step Therapy)
  • Hydrocortisone W/ Acetic Acid Otic Soln 1-2% (Quantity Level Limit)
  • Lidocaine Oint 5% (Quantity Level Limit)
  • Liothyronine Sodium Tab 25 Mcg (Quantity Level Limit)
  • Permethrin Cream 5% (Quantity Level Limit)
  • Permethrin Lotion 1% (Quantity Level Limit)
  • Prednicarbate Oint 0.1% (Quantity Level Limit)
  • Proton Pump Inhibitors (Quantity Level Limit)
  • Pyrethrins-Piperonyl Butoxide Liq 0.33-4% (Quantity Level Limit)
  • Ropinirole Hydrochloride Tab Er 24hr 12 Mg (Step Therapy)
  • Ropinirole Hydrochloride Tab Er 24hr 2 Mg (Step Therapy)
  • Ropinirole Hydrochloride Tab Er 24hr 4 Mg (Step Therapy)
  • Ropinirole Hydrochloride Tab Er 24hr 6 Mg (Step Therapy)
  • Ropinirole Hydrochloride Tab Er 24hr 8 Mg (Step Therapy)
  • Sulfacetamide Sodium Lotion 10% (Acne) (Quantity Level Limit)

 

July 2020

Additions:

  • Fluticasone-Salmeterol 113-14 (Age Limit)
  • Fluticasone-Salmeterol 232-14 (Age Limit)
  • Fluticasone-Salmeterol 55-14 (Age Limit)
  • Gvoke Pfs (Quantity Level Limit)
  • Invokamet 150-1,000mg Tablet (Step Therapy)
  • Invokamet 150-500mg Tablet (Step Therapy)
  • Invokamet 50-1,000mg Tablet (Step Therapy)
  • Invokamet 50-500 Mg Tablet (Step Therapy)
  • Invokamet Xr 150-1,000 Mg Tab (Step Therapy)
  • Invokamet Xr 150-500mg Tablet (Step Therapy)
  • Invokamet Xr 50-1,000 Mg Tab (Step Therapy)
  • Invokamet Xr 50-500mg Tablet (Step Therapy)
  • Pegintron 50 Mcg Kit (Prior Authorization)
  • Solifenacin 10 Mg Tablet
  • Solifenacin 5 Mg Tablet
  • Xigduo Xr 10 Mg-500mg Tablet (Step Therapy)
  • Xigduo Xr 10mg-1,000 Mg Tab (Step Therapy)
  • Xigduo Xr 2.5mg-1,000 Mg Tab (Step Therapy)
  • Xigduo Xr 5 Mg-1,000mg Tablet (Step Therapy)
  • Xigduo Xr 5 Mg-500mg Tablet (Step Therapy)

Removals:

  • Dyanavel Xr 2.5mg/Ml Susp
  • Quillichew Er 20 Mg Chew Tab
  • Quillichew Er 30 Mg Chew Tab
  • Quillichew Er 40 Mg Chew Tab
  • Quillivant Xr 25 Mg/5ml Susp
  • Relpax 20 Mg Tablet
  • Relpax 40 Mg Tablet
  • Testosterone Gel 20.25 Mg/ 1.25 Gm (1.62%) Transdermal
  • Testosterone Gel 40.5 Mg/ 2.5 Gm (1.62%) Transdermal
  • Vesicare 10mg Tablet
  • Vesicare 5mg Tablet

 

June 2020

Additions:

  • Alahist D Tab             
  • Dovato Tab 50-300mg (Quantity Level Limit)
  • Gvoke Hypopen Inj (Quantity Level Limit)            
  • Atovaquone-Proguanil Tablets 250-100mg (Quantity Level Limit)
  • Atovaquone-Proguanil Tablets 62.5-25mg (Quantity Level Limit)
  • Primaquine Tablet 26.3 Mg (Quantity Level Limit)
  • Phenazopyridine Tab 95 Mg
  • Phenytoin Chew Tab 50mg

Removals:

  • Dilantin Chew Tab 50mg
  • Nicotrol Inhaler 10 Mg Inhalation,
  • Nicotrol NS Solution 10mg/Ml Nasal
  • Phenytoin Sodium Extended Cap 30 Mg
  • Humalog Kwikpen Solution Pen-Injector 200 Unit/ML Subcutaneous
  • Permethrin Cream 5%
  • Calcium Acetate (Phosphate Binder) CAP 667 Mg

Other Updates:

  • Lancets (Quantity Level Limit)
  • Alcohol Swabs (Quantity Level Limit)
  • Collagenase Ointment 250 Unit/Gm (Quantity Level Limit)
  • Insulin Syringe (Disp) U-100 0.3 Ml (Quantity Level Limit)
  • Insulin Syringe (Disp) U-100 1/2 Ml (Quantity Level Limit)
  • Insulin Syringe (Disp) U-100 1 Ml (Quantity Level Limit)
  • Insulin Syringe/Needle U-100 0.3 Ml 29 G (Quantity Level Limit)
  • Insulin Syringe/Needle U-100 0.3 Ml 30 G (Quantity Level Limit)
  • Insulin Syringe/Needle U-100 0.3 Ml 29 X 1/2" (Quantity Level Limit)
  • Insulin Syringe/Needle U-100 0.3 Ml 30 X 5/16" (Quantity Level Limit)
  • Insulin Syringe/Needle U-100 0.3 Ml 30 X 1/2" (Quantity Level Limit)
  • Insulin Syringe/Needle U-100 1/2 Ml 27 X 1/2" (Quantity Level Limit)
  • Insulin Syringe/Needle U-100 1/2 Ml 29 G (Quantity Level Limit)
  • Insulin Syringe/Needle U-100 1/2 Ml 30 G (Quantity Level Limit)
  • Insulin Syringe/Needle U-100 1/2 Ml 30 X 3/8" (Quantity Level Limit)
  • Insulin Syringe/Needle U-100 1/2 Ml 31 X 5/16" (Quantity Level Limit)
  • Insulin Syringe/Needle U-100 1/2 Ml 28 X 5/16" (Quantity Level Limit)
  • Insulin Syringe/Needle U-100 1/2 Ml 28 X 1/2" (Quantity Level Limit)
  • Insulin Syringe/Needle U-100 1/2 Ml 29 X 5/16" (Quantity Level Limit)
  • Insulin Syringe/Needle U-100 1/2 Ml 29 X 1/2" (Quantity Level Limit)
  • Insulin Syringe/Needle U-100 1/2 Ml 30 X 5/16" (Quantity Level Limit)
  • Insulin Syringe/Needle U-100 1/2 Ml 30 X 1/2" (Quantity Level Limit)
  • Insulin Syringe/Needle U-100 1 Ml 25 X 5/8" (Quantity Level Limit)
  • Insulin Syringe/Needle U-100 0.3 Ml 31 X 15/64" (Quantity Level Limit)
  • Insulin Syringe/Needle U-100 1 Ml 25 X 1" (Quantity Level Limit)
  • Insulin Syringe/Needle U-100 1 Ml 26 X 1/2" (Quantity Level Limit)
  • Insulin Syringe/Needle U-100 1 Ml 27 X 1/2" (Quantity Level Limit)
  • Insulin Syringe/Needle U-100 1 Ml 27 X 5/8" (Quantity Level Limit)
  • Insulin Syringe/Needle U-100 1 Ml 28 X 5/16" (Quantity Level Limit)
  • Insulin Syringe/Needle U-100 1 Ml 28 X 1/2" (Quantity Level Limit)
  • Insulin Syringe/Needle U-100 1 Ml 29 X 1/2" (Quantity Level Limit)
  • Insulin Syringe/Needle U-100 1 Ml 29 X 5/16" (Quantity Level Limit)
  • Insulin Syringe/Needle U-100 1 Ml 30 G (Quantity Level Limit)
  • Insulin Syringe/Needle U-100 1 Ml 30 X 5/16" (Quantity Level Limit)
  • Insulin Syringe/Needle U-100 1 Ml 30 X 1/2" (Quantity Level Limit)
  • Insulin Syringe/Needle U-100 1 Ml 31 X 5/16" (Quantity Level Limit)
  • Insulin Syringe/Needle U-100 0.3 Ml 31 X 5/16" (Quantity Level Limit)
  • Insulin Syringe/Needle U-100 2 Ml 27.5 X 5/8" (Quantity Level Limit)
  • Insulin Syringe/Needle U-100 1/2 Ml 31 X 15/64" (Quantity Level Limit)
  • Insulin Syringe/Needle U-100 0.3 Ml 29 X 1" (Quantity Level Limit)
  • Insulin Syringe/Needle U-100 1 Ml 31 X 15/64" (Quantity Level Limit)
  • Umeclidinium-Vilanterol Aero Powd Ba 62.5-25 Mcg/Inh (Age Limit)
  • Tiotropium Br-Olodaterol Inhal Aero Soln 2.5-2.5 Mcg/Ac (Age Limit)
  • Clotrimazole 1% Solution (Rx) (Step Therapy Removed)
  • Tramadol Hcl Tab 50 Mg (Age Limit)
  • Tramadol Hcl Tab 100 Mg (Age Limit)
  • Metformin Hcl Tab 500 Mg (Age Limit)
  • Metformin Hcl Tab 850 Mg (Age Limit)
  • Metformin Hcl Tab 1000 Mg (Age Limit)
  • Metformin Hcl Tab Sr 24hr 500 Mg (Age Limit)
  • Metformin Hcl Tab Sr 24hr 750 Mg (Age Limit)

 

May 2020

Additions:

  • Dexameth Pho Inj 20mg/5ml
  • Dexameth Pho Mdv 10mg/Ml
  • Dexameth Pho Via 120mg/30
  • Dexamethason Con 1mg/Ml
  • Dexamethason Via 10mg/Ml
  • Dexamethason Via 4mg/Ml
  • Hydrocortisone Sodium Succinate Pf For Inj 100 Mg
  • Hydrocortisone Sodium Succinate Pf For Inj 1000 Mg
  • Hydrocortisone Sodium Succinate Pf For Inj 250 Mg
  • Hydrocortisone Sodium Succinate Pf For Inj 500 Mg
  • Pyrimethamine Tab 25mg (Prior Authorization Required)

Removals:

  • Daraprim Tab 25mg
  • Diphenhydramine-Acetaminophen Tab 12.5-325 Mg
  • Phytonadione (Bulk)

 

April 2020

Additions:

  • Moxifloxacin Ophth Sol 0.5%
  • Omeprazole Tablet Delayed Release Disintegrating 20 Mg
  • Orkambi Granules 100-125 Mg (Prior Authorization Required)
  • Orkambi Granules 200-125 Mg (Prior Authorization Required)
  • Orkambi Tab 100-125 Mg (Prior Authorization Required)
  • Orkambi Tab 200-125 Mg (Prior Authorization Required)
  • Pantoprazole Sodium Ec Tab 20 Mg
  • Pantoprazole Sodium Ec Tab 40 Mg
  • Tramadol Hcl Tab 100mg (Quantity Level Limit)     

 

March 2020

Additions:

  • Gel-One Inj 30mg/3mL (Prior Authorization Required)
  • Hyalgan Inj 20mg/2mL (Prior Authorization Required)   
  • Penicillamine Tab 250mg (Prior Authorization Required, Quantity Limit)

Removals:

  • Allevyn Ag Pad 3"X3"
  • Allevyn Ag Pad 3"X3"
  • Allevyn Ag Pad 5"X5"
  • Allevyn Ag Pad 5"X5"
  • Allevyn Ag Pad 7"X7"
  • Allevyn Ag Pad 7"X7"
  • Bp Wash Liq 7%
  • Bp Wash Liq 7%
  • Cem-Urea Sol 45%
  • Cem-Urea Sol 45%
  • Cyanocobalam Cry
  • Cyanocobalam Cry
  • Fluoritab Dro 0.125mg
  • Isop Alcohol Sol 70%
  • Isop Alcohol Sol 70%
  • Prevident Sol Rinse
  • Propylene Liq Glycol
  • Propylene Liq Glycol
  • Restore Silv Pad 2"X2"
  • Restore Silv Pad 2"X2"
  • Restore Silv Pad 4"X4.75"
  • Restore Silv Pad 4"X4.75"
  • Salicylic Ac Sol 26%
  • Salicylic Ac Sol 26%
  • Urea Cre 45%
  • Urea Cre 45%

 

February 2020

Additions:

  • Bimatoprost sol 0.03% (Step Therapy Required)

Removals:

  • Alprazolam Concentrate 1MG/ML Solution
  • Chlorothiazide Tabs 250mg
  • Chlorothiazide Tabs 500mg
  • Demeclocycline 150mg Tablet
  • Demeclocycline 300mg Tablet
  • Doxycycline Monohydrate Tab 150mg
  • First-vanco Sol 25mg/ml
  • First-vanco Sol 50mg/ml
  • Methyclothiazide Tab 5MG
  • Nausea Liquid Relief (fructose-dextrose-phosphoric acid)
  • Nizatidine Soln 15MG/ML
  • Phospholine (ECHOTHIOPHATE IODIDE) opth solution 0.125%
  • Propantheline 15mg Cap
  • Rabeprazole EC 20mg Cap
  • Ranitidine Capsule 150 mg
  • Ranitidine Capsule 300 mg

Other Updates:

  • Atropine sul oin 1% op (Quantity Level Limit Added)
  • Atropine sul sol 1% op (Quantity Level Limit Added)
  • Buspirone tab 10mg (Age Limit Added)
  • Buspirone tab 15mg (Age Limit Added)
  • Buspirone tab 5mg (Age Limit Added)
  • Buspirone tab 7.5mg (Age Limit Added)
  • Doxycycline monohydrate susp 25mg/5ml (Age Limit Added)
  • Granisetron tab 1mg (Step Therapy Required)
  • Hydroxyz hcl syp 10mg/5ml (Quantity Level Limit Added)
  • Hydroxyz pam cap 100mg (Quantity Level Limit Added)
  • Hydroxyz pam cap 25mg (Quantity Level Limit Added)
  • Hydroxyz pam cap 50mg (Quantity Level Limit Added)
  • Ibandronate inj 3mg/3ml (Quantity Level Limit Added)
  • Levofloxacin sol 0.5% (Quantity Level Limit Added)
  • Lorazepam con 2mg/ml (Quantity Level Limit Added, Age Limit Added)
  • Methazolamide tab 50 mg (Step Therapy Required)
  • Methazolamide tab 25 mg (Step Therapy Required)
  • Natacyn sus 5% op (Quantity Level Limit Added)
  • Tazarotene cre 0.1% (Step Therapy Required)
  • Trifluridine sol 1% op (Quantity Level Limit Added)

 

January 2020

Additions:

  • Alyq 20mg Tab (Prior Authorization Required)
  • Clobazam Tab 10mg (Prior Authorization Required, Age Limit Added)
  • Clobazam Tab 20mg (Prior Authorization Required, Age Limit Added)
  • Irbesartan-HCTZ Tab 150-12.5mg
  • Irbesartan-HCTZ Tab 300-12.5mg
  • Mesalamine DR 1.2gm Tab
  • Norditropin flexpro 10mg/1.5 (Prior Authorization Required)
  • Norditropin flexpro 15mg/1.5 (Prior Authorization Required)
  • Norditropin flexpro 30mg/1.5 (Prior Authorization Required)
  • Norditropin flexpro 5mg/1.5 (Prior Authorization Required)
  • Olmesartan Medoxomil Tab 20mg
  • Olmesartan Medoxomil Tab 40mg
  • Olmesartan Medoxomil Tab 5mg
  • Olmesartan-HCTZ Tab 20-12.5mg
  • Olmesartan-HCTZ Tab 40-12.5mg
  • Olmesartan-HCTZ Tab 40-25mg
  • Phenytoin 100mg Cap
  • Rhopressa 0.02% Ophth Soln
  • Rocklatan 0.02%-0.005% Ophth Soln
  • Sevelamer 800mg Tab

Removals:

  • Dilantin 100mg Cap
  • Levocetirizine 5mg Tab OTC
  • Lialda DR 1.2gm Tab
  • Moxifloxacin 0.5% Ophth Soln
  • Nutropin AQ Nuspin 10 Inj
  • Nutropin AQ Nuspin 20 Inj
  • Nutropin AQ Nuspin 5 Inj
  • Renvela 800mg Tab
  • Simbrinza 1%-0.2% Ophth Soln

Other Updates:

  • Pregabalin Caps (Removed Step Therapy)

 

December 2019

No Changes

 

November 2019

No Changes

 

October 2019

No Changes

 

September 2019

Additions:

  • Ambrisentan Tab 10mg (Age Limit Added)  
  • Ambrisentan Tab 5mg (Age Limit Added)  
  • Bosentan Tab 125mg (Age Limit Added)  
  • Bosentan Tab 62.5mg (Age Limit Added)   
  • Febuxostat Tab 40mg  (Step Therapy Required) 
  • Febuxostat Tab 80mg (Step Therapy Required)
  • Fluticasone/Salmeterol Inhalers 100-50mcg, 250-50mcg, 500-50mcg (Age Limit)
  • Pregabalin Caps (Step Therapy Required)
  • Ramelteon Tab 8mg (Step Therapy Required)

Removals:

  • Advair Diskus (Brand)
  • Lyrica Caps (Brand)
  • Rozerem Tab 8mg
  • Uloric Tab 40mg
  • Uloric Tab 80mg

 

August 2019

Additions:

  • Butenafine HCL Cream 1%
  • Emtricitabine-Rilpivirine-Tenofovir Af Tab 200-25-25 mg (Quantity Level Limit)
  • Lidocaine Crm 4%
  • Lidocaine Patch 4% (Quantity Level Limit)
  • NP Thyroid 120mg Tab (Quantity Level Limit)
  • NP Thyroid 15mg Tab (Quantity Level Limit)
  • NP Thyroid 30mg Tab (Quantity Level Limit)
  • Pegfilgrastim-Cbqv Soln Prefilled Syr 6 Mg/0.6mL (Prior Authorization Required)
  • Pegfilgrastim-Jmdb Soln Prefilled Syr 6 Mg/0.6mL (Prior Authorization Required)
  • Thyroid 120mg Tab (Quantity Level Limit)
  • Thyroid 15mg Tab (Quantity Level Limit)
  • Thyroid 30mg Tab (Quantity Level Limit)

Other Updates:

  • Abacavir Sulfate Soln 20 Mg/mL (Base Equiv) (Quantity Level Limit Added)
  • Abacavir Sulfate Tab 300 Mg (Base Equiv) (Quantity Level Limit Added)
  • Abacavir Sulfate-Lamivudine Tab 600-300mg (Quantity Level Limit Added)
  • Abacavir Sulfate-Lamivudine-Zidovudine Tab 300-150-300mg (Quantity Level Limit Added)
  • Armour Thyroid 180mg Tab (Quantity Level Limit)
  • Armour Thyroid 240mg Tab (Quantity Level Limit)
  • Armour Thyroid 300mg Tab (Quantity Level Limit)
  • Aspercreme Cre Lidoc 4% (Quantity Level Limit Added)
  • Aspercreme Cre Lidoc 4% (Quantity Level Limit Added)
  • Atazanavir Sulfate Oral Powder Packet 50 Mg (Base Equiv) (Quantity Level Limit Added)
  • Atazanavir Sulfate-Cobicistat Tab 300-150mg (Base Equiv) (Prior Authorization, Quantity Limit Added)
  • Azelastine HCL Ophth Soln 0.05% (Quantity Level Limit Added)
  • Betamethasone Dipropionate Oint 0.05% (Quantity Level Limit Added)
  • Ciclopirox Olamine Cream 0.77% (Step Therapy Added)
  • Ciclopirox Olamine Susp 0.77% (Step Therapy Added)
  • Ciclopirox Shampoo 1% (Step Therapy Added)
  • Clotrimazole Soln 1% (Rx Only) (Step Therapy Added)
  • Darunavir-Cobic-Emtricitab-Tenofov Af Tab 800-150-200-10mg (Quantity Level Limit Added)
  • Darunavir-Cobicistat Tab 800-150mg (Prior Authorization, Quantity Limit Added)
  • Delavirdine Mesylate Tab 200mg (Prior Authorization, Quantity Limit Added)
  • Didanosine Delayed Release Capsule 200 Mg (Quantity Level Limit Added)
  • Didanosine Delayed Release Capsule 250 Mg (Quantity Level Limit Added)
  • Didanosine Delayed Release Capsule 400 Mg (Quantity Level Limit Added)
  • Didanosine For Soln 2 Gm (Quantity Level Limit Added)
  • Didanosine For Soln 4 Gm (Quantity Level Limit Added)
  • Dolutegravir Sodium-Rilpivirine HCL Tab 50-25mg (Base Eq) (Prior Authorization Required)
  • Efavirenz Cap 200mg (Quantity Level Limit Added)
  • Efavirenz Cap 50mg (Quantity Level Limit Added)
  • Efavirenz Tab 600mg (Quantity Level Limit Added)
  • Elvitegrav-Cobic-Emtricitab-Tenofovdf Tab 150-150-200-300mg (Prior Authorization Required)
  • Emtricitabine Caps 200mg (Quantity Level Limit Added)
  • Emtricitabine Soln 10mg/mL (Quantity Level Limit Added)
  • Emtricitabine-Rilpivirine-Tenofovir Df Tab 200-25-300mg (Quantity Level Limit Added)
  • Enfuvirtide For Inj 90 mg (Prior Authorization, Quantity Limit Added)
  • Etravirine Tab 100mg (Prior Authorization, Quantity Limit Added)
  • Etravirine Tab 200mg (Prior Authorization, Quantity Limit Added)
  • Etravirine Tab 25mg (Prior Authorization Required)
  • Fluocinolone Acetonide Cream 0.025% (Quantity Level Limit Added)
  • Fluocinolone Acetonide Oint 0.025% (Quantity Level Limit Added)
  • Fosamprenavir Calcium Susp 50mg/mL (Base Equiv) (Prior Authorization, Quantity Limit Added)
  • Fosamprenavir Calcium Tab 700mg (Base Equiv) (Prior Authorization, Quantity Limit Added)
  • Gilenya Cap 0.5mg (Step Therapy Added)
  • Griseofulvin Tab Micr 500 (Step Therapy Added)
  • Griseofulvin Tab Ultr 125mg (Step Therapy Added)
  • Griseofulvin Tab Ultr 250mg (Step Therapy Added)
  • Indinavir Sulfate Cap 200mg (Prior Authorization, Quantity Limit Added)
  • Indinavir Sulfate Cap 400mg (Prior Authorization, Quantity Limit Added)
  • Lamivudine Oral Soln 10mg/mL (Quantity Level Limit Added)
  • Lamivudine Tab 150mg (Quantity Level Limit Added)
  • Lamivudine Tab 300mg (Quantity Level Limit Added)
  • Lamivudine-Zidovudine Tab 150-300mg (Quantity Level Limit Added)
  • Lidocaine 5% Ointment (Prior Authorization Required)
  • Lidocaine HCL Gel 2% (Quantity Level Limit Added)
  • Lidocaine-Prilocaine Cre 2.5-2.5% (Quantity Level Limit Added)
  • Liothyronine Sodium Tab 50mcg (Quantity Level Limit Added)
  • Liothyronine Sodium Tab 5mcg (Quantity Level Limit Added)
  • Lopinavir-Ritonavir Soln 400-100mg/5ml (80-20 Mg/mL) (Prior Authorization, Quantity Limit Added)
  • Lopinavir-Ritonavir Tab 100-25mg (Prior Authorization, Quantity Limit Added)
  • Lopinavir-Ritonavir Tab 200-50mg (Prior Authorization, Quantity Limit Added)
  • Maraviroc Tab 150mg (Prior Authorization Required)
  • Maraviroc Tab 25mg (Prior Authorization Required)
  • Maraviroc Tab 300mg (Prior Authorization Required)
  • Maraviroc Tab 75mg (Prior Authorization Required)
  • Nelfinavir Mesylate Tab 250mg (Prior Authorization, Quantity Limit Added)
  • Nelfinavir Mesylate Tab 625mg (Prior Authorization, Quantity Limit Added)
  • Nevirapine Susp 50mg/5mL (Quantity Level Limit Added)
  • Nevirapine Tab 200mg (Quantity Level Limit Added)
  • Nevirapine Tab ER 24hr 100mg (Quantity Level Limit Added)
  • Nevirapine Tab ER 24hr 400mg (Quantity Level Limit Added)
  • Norethindrone Tab 0.35 Mg (Step Therapy Added)
  • Pegfilgrastim-Cbqv Soln Prefilled Syringe 6mg/0.6ml (Prior Authorization Required)
  • Pegfilgrastim-Jmdb Soln Prefilled Syringe 6mg/0.6ml (Prior Authorization Required)
  • Raltegravir Potassium Packet For Susp 100 Mg (Base Equiv) (Quantity Level Limit Added)
  • Rilpivirine HCL Tab 25mg (Base Equivalent) (Quantity Level Limit Added)
  • Ritonavir Oral Soln 80 Mg/mL (Quantity Level Limit Added)
  • Ritonavir Tab 100 Mg (Quantity Level Limit Added)
  • Sertraline HCL Oral Concentrate For Solution 20mg/mL (Age Limit Added)
  • Stavudine Cap 15mg (Quantity Level Limit Added)
  • Stavudine Cap 20mg (Quantity Level Limit Added)
  • Stavudine Cap 30mg (Quantity Level Limit Added)
  • Tenofovir Disoproxil Fumarate Oral Powder 40mg/GM (Prior Authorization, Quantity Limit Added)
  • Thyroid Tab 60mg (1 Grain) (Quantity Level Limit Added)
  • Thyroid Tab 90mg (1 1/2 Grain) (Quantity Level Limit Added)
  • Zidovudine Cap 100mg (Quantity Level Limit Added)
  • Zidovudine Syrup 10mg/mL (Quantity Level Limit Added)
  • Zidovudine Tab 300mg (Quantity Level Limit Added)

Removals:

  • Armour Thyroid 120mg Tab
  • Armour Thyroid 15mg Tab
  • Armour Thyroid 30mg Tab
  • Aubagio Tab 14mg
  • Aubagio Tab 7mg
  • Butalbital-Acetaminophen-Caff W/ Cod Cap 50-300-40-30mg
  • Butalbital-Acetaminophen-Caffeine Cap 50-300-40mg
  • Butalbital-Acetaminophen-Caffeine Cap 50-325-40mg
  • Calcium Acetate (Phosphate Binder) Oral Soln 667 Mg/5mL
  • Ciclopirox Gel 0.77%
  • Clotrimazole W/ Betamethasone Lotion 1-0.05%
  • Colestipol HCL Granule Packets 5 GM
  • Colestipol HCL Granules 5 GM
  • Entecavir Oral Soln 0.05 Mg/mL
  • Epinastine HCL Ophth Soln 0.05%
  • Esterified Estrogens Tab 0.3mg
  • Esterified Estrogens Tab 0.625mg
  • Esterified Estrogens Tab 1.25mg
  • Estradiol Tab 1 mg(15)/Estrad-Norgestimate Tab 1-0.09mg(15)
  • Etodolac Tab ER 24hr 400mg
  • Etodolac Tab ER 24hr 500mg
  • Etodolac Tab ER 24hr 600mg
  • Extavia Inj 0.3mg
  • Extavia Inj 0.3mg
  • Extavia Inj 0.3mg
  • HC Valerate Cre 0.2%
  • HC Valerate Oin 0.2%
  • LC-4 Lidocaine 4%
  • Lidocaine-Prilocaine Cream Kit 2.5-2.5%
  • Lindane Shampoo 1%
  • LMX 4 Crm 4%
  • Metformin HCL Tab ER 24hr Modified Release 1000 mg
  • Metformin HCL Tab ER 24hr Modified Release 500 mg
  • Moexipril HCL Tab 15mg
  • Moexipril HCL Tab 7.5mg
  • Naproxen Sodium Tab ER 24hr 375 Mg (Base Equiv)
  • Naproxen Sodium Tab ER 24hr 500 Mg (Base Equiv)
  • Olopatadine HCL Ophth Soln 0.2%
  • Quinidine Gluconate Tab ER 324 mg
  • Tecfidera Cap 120mg
  • Tecfidera Cap 240mg
  • Tecfidera Mis Starter

 

July 2019

Additions:

  • Budesonide 0.25mg/2mL Inh Sus
  • Budesonide 0.5mg/2mL Inh Sus
  • Budesonide 1mg/2mL Inh Sus
  • Cefixime 400mg Cap
  • Dalfampridine ER 10mg Tab
  • Dyanavel Xr 2.5 MG/mL Sus (Prior Authorization Required, Age Limit Added)
  • Emgality 120mg-mL Pen (Prior Authorization Required, Age Limit Added)
  • Emgality 120mg-mL Syr (Prior Authorization Required, Age Limit Added)
  • Erlotinib 150mg Tab (Prior Authorization, Quantity Limit Added)
  • Kitabis Pak Neb 300/5mL (Quantity Limit Added, Age Limit Added)
  • Mesalamine 400mg Cap
  • Sofosbuvir-Velpatasvir 400-100mg
  • Solifenacin 10mg Tab
  • Solifenacin 5mg Tab
  • Sublocade 100 MG/0.5 mL Syr (Prior Authorization Required)
  • Sublocade 300 MG/1.5 mL Syr (Prior Authorization Required)
  • Testosterone 1.62% (1.25 G) Pkt (Prior Authorization Required, Age Limit Added)
  • Testosterone 1.62% (2.5 G) Pkt (Prior Authorization Required, Age Limit Added)
  • Testosterone 1.62% Gel Pump (Prior Authorization Required, Age Limit Added)
  • Testosterone 12.5 MG/1.25 GM (Prior Authorization Required, Age Limit Added)
  • Testosterone 25 MG/2.5 GM Pkt (Prior Authorization Required, Age Limit Added)
  • Testosterone 50 MG/5 GM Pkt (Prior Authorization Required, Age Limit Added)
  • Tobramycin Neb 300/5mL (Quantity Limit Added, Age Limit Added)
  • Xarelto Starter Pack

Other Updates:

  • Atomoxetine HCL 100Mg Cap (Age Limit Removed)
  • Atomoxetine HCL 10Mg Cap (Age Limit Removed)
  • Atomoxetine HCL 18Mg Cap (Age Limit Removed)
  • Atomoxetine HCL 25Mg Cap (Age Limit Removed)
  • Atomoxetine HCL 40Mg Cap (Age Limit Removed)
  • Atomoxetine HCL 60Mg Cap (Age Limit Removed)
  • Atomoxetine HCL 80Mg Cap (Age Limit Removed)
  • Clonidine HCL ER 0.1Mg Tab (Age Limit Removed)
  • Guanfacine HCL ER 1Mg Tab (Age Limit Removed)
  • Guanfacine HCL ER 2Mg Tab (Age Limit Removed)
  • Guanfacine HCL ER 3Mg Tab (Age Limit Removed)
  • Guanfacine HCL ER 4Mg Tab (Age Limit Removed)
  • Tramadol-Acetaminophn 37.5-325mg (Age Limit Removed)

Removals:

  • Ampyra Tab 10mg
  • AndroGel Gel 20.25mg-1.25GM (1.62%)
  • AndroGel Gel 25mg-2.5GM (1%)
  • AndroGel Gel 40.5mg-2.5GM (1.62%)
  • AndroGel Gel 50mg-5GM (1%)
  • AndroGel Pump Gel 20.25mg (1.62%)
  • Aranesp 10 MCG/0.4 mL Syr
  • Aranesp 100 MCG/0.5 mL Syr
  • Aranesp 100 MCG/mL Vial
  • Aranesp 150 MCG/0.3mL Syr
  • Aranesp 200 MC /mL Vial
  • Aranesp 200 MCG/0.4mL Syr
  • Aranesp 25 MCG/0.42mL Syr
  • Aranesp 25 MCG/mL Vial
  • Aranesp 300 MCG/0.6mL Syr
  • Aranesp 300 MCG/mL Vial
  • Aranesp 40 MCG/0.4mL Syr
  • Aranesp 40 MCG/mL Vial
  • Aranesp 500 MCG/1mL Syr
  • Aranesp 60 MCG/0.3mL Syr
  • Aranesp 60 MCG/mL Vial
  • Cefixime 100mg/5mL Sus
  • Cefixime 200mg/5mL Sus
  • Delzicol Cap 400mg
  • Ery-Tab Ec 250mg Tablet
  • Ery-Tab Ec 333mg Tablet
  • Ery-Tab Ec 500mg Tablet
  • Erythrocin 250mg Film tab
  • Erythromycin Es 400mg Tab
  • Procrit 10,000 Units/mL Vial
  • Procrit 2,000 Units/mL Vial
  • Procrit 20,000 Units/mL Vial
  • Procrit 3,000 Units/mL Vial
  • Procrit 4,000 Units/mL Vial
  • Procrit 40,000 Units/mL Vial
  • Pulmicort Sus 0.25mg-2mL
  • Pulmicort Sus 0.5mg-2mL
  • Pulmicort Sus 1mg-2mL
  • Relenza 5mg Diskhaler
  • Suprax Cap 400mg
  • Tarceva Tab 150mg
  • Testim Gel 50mg-5GM (1%)
  • Tobramycin Neb 300/5mL
  • Vogelxo Pump Gel 12.5mg (1%)
  • Vogelxo Pump Gel 50mg-5GM (1%)

We want you to be as healthy as possible. And you’ll want to know more about the different medicines you take. To help you, here’s a list of questions you should always ask your provider when he or she gives you a prescription:

  • Why am I taking this medicine?
  • What is it supposed to do for me?
  • How should I take this medicine? When? For how many days?
  • Are there any side effects or possible allergic reactions to this medicine?
  • What should I do if I have a side effect or allergic reaction?
  • What will happen if I don't take this medicine?

Carefully read the drug information given with your medicine. It will tell you what you should and shouldn’t do while taking the medicine. If you still have questions after you get your medicine, ask to speak with the pharmacist or call your provider.

Questions about your pharmacy benefits?

Please call Member Services. We are here to help.

Medallion/FAMIS – Member Services

1-800-279-1878 (TTY 711)
24 hours a day, 7 days a week

CCC Plus – Member Services

1-855-652-8249 (TTY 711)
24 hours a day, 7 days a week

HMO SNP - Member Services


1-855-463-0933 (TTY users should call 711)
24 hours a day, 7 days a week