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For Exchange plans, OTC drugs or their prescription equivalents will no longer be covered after Jan. 1

12/12/2017

We will no longer cover over-the-counter (OTC) drugs or their prescription equivalents for your patients with ConnectiCare plans purchased through Access Health CT, the state insurance exchange, starting Jan. 1, 2018.

The one exception is Nexium OTC, which we will continue to cover as long as it is prescribed by a doctor.

This change is consistent with our policy for your ConnectiCare patients with employer-sponsored coverage.

Your patients with Medicare Advantage plans or employer-sponsored plans for municipalities are not affected by this change in OTC coverage. It’s best to refer to your patient’s formulary before prescribing any medication.

This change may also affect some of our step therapy treatments, so please refer to the pharmacy section of our website for updates.

We are letting your patients know about this formulary change and that it means they will have to pay a store’s listed cost of OTC drugs, such as:

Therapeutic class

Medications

Antihistamines

Allegra, Claritin, Xyzal, Zyrtec

Gastrointestinal medications

Axid, Pepcid, Prevacid, Prilosec, Tagamet, Zantac, Zegerid

Nasal steroids

Flonase, Flonase Sensimist, Nasacort, Veramyst, Rhinocort

Ophthalmic antihistamines

Alaway, Zaditor

Topical acne products

Differin Gel 0.1%