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Participating Pharmacies:

What drugs are not covered under most insurance plans and prescription drug programs?

• Infertility medications when used for assisted reproduction.
• Drugs prescribed, dispensed, or intended for use while in a hospital, skilled nursing facility or alternate facility.
• Drug products for any condition, injury, sickness or mental illness arising out of, or in the course of, employment for which benefits are available under any workers' compensation or other similar laws.
• Drugs administered at a doctor's office or hospital, including allergy serum, immunizations, biological sera, blood, or blood plasma. However, these may be covered under the medical plan.
• OTC products that do not require a prescription or any prescription medication that is available as an OTC medication. Exceptions are insulin and niacin.
• Drugs used for investigational purposes or experimental indications, drugs with no approved FDA indications.
• Implantable or injectable contraceptives.
• Injectable drugs, except when the drug can be self-administered, as defined by the plan. Other injectables may be covered under the medical plan.
• Unit dose or convenience packaging of prescription drug products.
• Durable medical equipment, prescribed and non-prescribed outpatient supplies, other than selected diabetic supplies.
• Anabolic steroids except testosterone.
• Drugs used for cosmetic purposes or aesthetic enhancement.

Health Provider Drug Formulary Reference Lists

Most health plans have a formulary list of prescription drugs, both generic and brand name that are covered through your health plan. Your health plan may only pay for medications that are on the formulary. Medication not found on these lists are considered non-covered drugs. Below are links to the drug formularies from some of the major health providers.

Aetna Health Insurance

• Aetna preferred drug list / brand and generic drug FAQs
• Aetna Medicare Drug Plans

Blue Cross of California

• Frequently Asked Questions: Drug Formulary
• Drug Database & Formulary
• Medicare Part D Formulary

CareFirst BlueCross BlueShield

• Prescription Drug Program

Cigna

• Cigna Medicare Rx (PDP) Drug List/Formulary
• Cigna HealthCare Prescription Drug List

Coventry

• Coventry Health Care - Medicare Formulary List of Drugs
• Coventry One - Health Coverage for Individuals and Families - Prescription Formulary

Humana

• Insurance through Employer - Humana Drug List
• Insurance for Individuals - Humana Drug List
• Humana Medicare Plans - Medicare Drug List

Highmark Blue Cross Blue Shield

• Progressive Formulary
• Comprehensive Formulary
• Medicare Rx Formulary

Independence Blue Cross

• Search Drug Formulary

WellCare

• WellCare Prescription Drug Plans
• WellCare Medicare Formulary Medication Guide
• WellCare Drug List (Formulary) Search Tool

United Health One

• Prescription Rx Health Coverage
• Medicare Solutions - Medicare Advantage Plans - Formularies (Drug Lists)