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2018 formulary changes for Medicare Advantage plans

01/18/2018

We’ve written to Medicare Advantage members with Part D coverage who may be affected by changes in how drugs are covered starting Jan. 1, 2018. We urged them to talk to their doctors about any possible prescription changes they may need before the new year.

Please support your patients who may be affected by:

  • Anticipating any changes in medications that may be needed,
  • Answering your patients’ questions, and
  • Writing new prescription orders for them, when needed, before Jan. 1. 

The changes to the formulary effective Jan. 1, 2018, will be:

Drugs no longer covered:
ABILIFY DESONIDE NITROSTAT
ACETAMINOPHEN-CODEINE SOLUTION ENABLEX PATADAY
AGGRENOX EPZICOM PREDNICARBATE
ALPRAZOLAM ER FLUOCINOLONE ACETONIDE 0.01% and 0.025% CREAM PRISTIQ ER
ALPRAZOLAM XR FLUOCINONIDE-E SEROQUEL XR
AZILECT GALANTAMINE ER SIMBRINZA
BENICAR GLEEVEC STRATTERA
BENICAR HCT HALOBETASOL PROPIONATE TAZORAC
BETAMETHASONE DIPROPIONATE AUGMENTED KLOR-CON M10 TEGRETOL XR
BETOPTIC S MIRTAZAPINE ODT TIKOSYN
BYETTA NAMENDA VOLTAREN GEL
CLOTRIMAZOLE 1% SOLUTION NASONEX VYTORIN
COPAXONE CRESTOR XARELTO
Drugs moving to a higher tier:
CLARAVIS JANTOVEN MOMETASONE FUROATE 50 MCG SPRAY
DICLOFENAC SODIUM GEL and TOPICAL SOLUTION LEVOXYL OLOPATADINE HCL
Drugs that will require preauthorization:
BUTALBIT-ACETAMINOPHEN-CAFF CP BUTALBITAL-ASA-CAFFEINE CAP
Drugs added to formulary:
CIPRODEX EPINEPHRINE AUTO-INJECT
CORLANOR NARCAN
COSENTYX PEN  
Drugs moving to a lower tier:
AMLODIPINE BESYLATE-BENAZEPRIL ENOXAPARIN SODIUM METHOTREXATE 2.5 MG TABLET
AMOXICILLIN FOSINOPRIL SODIUM QUINAPRIL HCL
BENAZEPRIL-HYDROCHLOROTHIAZIDE FOSINOPRIL-HYDROCHLOROTHIAZIDE QUINAPRIL HYDROCHLOROTHIAZIDE
CEPHALEXIN HYDROXYCHLOROQUINE SULFATE REPAGLINIDE
ENALAPRIL MALEATE IRBESARTAN VALSARTAN
ENALAPRIL-HYDROCHLOROTHIAZIDE IRBESARTAN-HYDROCHLOROTHIAZIDE VALSARTAN-HYDROCHLOROTHIAZIDE