PARAMOUNT ADVANTAGE COVID-19 – 90 DAY SUPPLY MAINTENANCE DRUG LIST EFFECTIVE AS OF 04/14/20
During the state of emergency declared due to the COVID-19 pandemic, Paramount is taking measures to reduce barriers to access to care, keep individuals healthy in the community to reduce hospital admissions, and to reduce administrative burden on hospitals and providers. Paramount allows 90-day supply (3 month supply) of maintenance medication during the COVID-19 pandemic. Please note that this list does not guarantee coverage and some of the medications on the list may also be subject to additional plan coverage rules. Due to the large number of available medicines, this list is not all inclusive. The COVID-19 90-day supply maintenance drug list is subject to change.
Maintenance drugs are prescriptions commonly used to treat conditions that are considered chronic or long-term. These conditions usually require regular, daily use of medicines. Examples of maintenance drugs are those used to treat high blood pressure, heart disease, asthma and diabetes.
Abilify Maintena Altoprev ACAMPROSATE CALCIUM Alvesco ACARBOSE AMANTADINE HCL ACEBUTOLOL HCL AMILORIDE & HYDROCHLOROTHIAZIDE ACETAZOLAMIDE AMILORIDE HCL AcipHex Sprinkle AMIODARONE HCL Adlyxin Amitiza Advair HFA AMITRIPTYLINE HCL Afrezza AMLODIPINE BESYLATE Aimovig AMLODIPINE BESYLATE-ATORVASTATIN CALCIUM AirDuo RespiClick AMLODIPINE BESYLATE-BENAZEPRIL HCL Ajovy AMLODIPINE BESYLATE-OLMESARTAN MEDOXOMIL ALBUTEROL SULFATE AMLODIPINE BESYLATE-VALSARTAN Albuterol Sulfate ER AMLODIPINE-VALSARTAN-HYDROCHLOROTHIAZIDE Aldactazide Amoxapine ALENDRONATE SODIUM ANAGRELIDE HCL ALFUZOSIN HCL ANASTROZOLE ALISKIREN FUMARATE Angeliq ALLOPURINOL Annovera Alogliptin Benzoate Anoro Ellipta Alogliptin-Metformin HCl Antara Alogliptin-Pioglitazone Apidra Alora Apidra SoloStar ALOSETRON HCL Aplenzin Alphagan P Aptiom 1 This document contains references to brand-name prescription drugs that are trademarks or registered trademarks of pharmaceutical manufacturers not affiliated with Paramount Advantage.
Arcapta Neohaler Breo Ellipta ARIPIPRAZOLE Brilinta Aristada BRIMONIDINE TARTRATE Armour Thyroid Brimonidine-Dorzolamide Arnuity Ellipta BROMOCRIPTINE MESYLATE Asmanex Brovana Asmanex HFA BUDESONIDE (INHALATION) ASPIRIN-DIPYRIDAMOLE Budesonide-Formoterol Fumarate ATENOLOL BUMETANIDE ATENOLOL & CHLORTHALIDONE BUPROPION HCL ATOMOXETINE HCL BuPROPion HCl ER (XL) ATORVASTATIN CALCIUM BUSPIRONE HCL Atrovent HFA Bydureon Auryxia Bydureon BCise Avandia Byetta Azasan Bystolic AZATHIOPRINE CALCITONIN (SALMON) Azopt CALCITRIOL Baclofen CALCIUM ACETATE (PHOSPHATE BINDER) Balcoltra CANDESARTAN CILEXETIL Banzel CANDESARTAN CILEXETIL-HYDROCHLOROTHIAZIDE BENAZEPRIL & HYDROCHLOROTHIAZIDE Caplyta BENAZEPRIL HCL CAPTOPRIL BENZTROPINE MESYLATE Captopril-Hydrochlorothiazide BETAXOLOL HCL Carbaglu BETAXOLOL HCL (OPHTH) CARBAMAZEPINE Betimol CARBIDOPA Betoptic-S CARBIDOPA-LEVODOPA Bevespi Aerosphere Carbidopa-Levodopa-Entacapone Bevyxxa Cardizem LA BiDil Cardura XL Bijuva CaroSpir BIMATOPROST Carteolol HCl Binosto CARVEDILOL BISOPROLOL & HYDROCHLOROTHIAZIDE CARVEDILOL PHOSPHATE BISOPROLOL FUMARATE CELECOXIB BLOOD GLUCOSE TEST STRIPS Celontin 2 This document contains references to brand-name prescription drugs that are trademarks or registered trademarks of pharmaceutical manufacturers not affiliated with Paramount Advantage.
CETIRIZINE HCL DESLORATADINE CEVIMELINE HCL Desloratadine Chlorothiazide DESMOPRESSIN ACETATE CHLORPROMAZINE HCL DESOGESTREL & ETHINYL ESTRADIOL CHLORTHALIDONE DESOGESTREL-ETHINYL ESTRADIOL (BIPHASIC) Cholbam DESOGESTREL-ETHINYL ESTRADIOL (TRIPHASIC) CHOLESTYRAMINE Desvenlafaxine ER CHOLESTYRAMINE LIGHT DESVENLAFAXINE SUCCINATE CHOLINE FENOFIBRATE Dexilant CILOSTAZOL Diacomit CIMETIDINE DIAZOXIDE CITALOPRAM HYDROBROMIDE DICLOFENAC POTASSIUM Climara Pro DICLOFENAC SODIUM CLOMIPRAMINE HCL DICLOFENAC W/ MISOPROSTOL CLONIDINE HCL DIFLUNISAL CLONIDINE HCL (ADHD) DIGOXIN CLOPIDOGREL BISULFATE Dilantin COLCHICINE W/ PROBENECID Dilatrate-SR COLESEVELAM HCL DILTIAZEM HCL COLESTIPOL HCL DILTIAZEM HCL COATED BEADS Combigan DILTIAZEM HCL EXTENDED RELEASE BEADS CombiPatch Dilt-XR Combivent Respimat Dipentum Consensi DIPYRIDAMOLE Corlanor DISOPYRAMIDE PHOSPHATE Creon DISULFIRAM CROMOLYN SODIUM Diuril Cuvposa DIVALPROEX SODIUM Cycloset Divigel Cyclosporine in Klarity (ophthalmic) DONEPEZIL HYDROCHLORIDE Cystadane DORZOLAMIDE HCL Cystaran Dorzolamide HCl-Timolol Mal Daliresp DORZOLAMIDE HCL-TIMOLOL MALEATE DAPSONE DOXAZOSIN MESYLATE DARIFENACIN HYDROBROMIDE DOXEPIN HCL Depo-SubQ Provera 104 Doxepin HCl DESIPRAMINE HCL DOXERCALCIFEROL 3 This document contains references to brand-name prescription drugs that are trademarks or registered trademarks of pharmaceutical manufacturers not affiliated with Paramount Advantage.
Drizalma Sprinkle Estring DROPERIDOL Estrogel Droperidol ETHACRYNIC ACID DROSPIRENONE-ETHINYL ESTRADIOL ETHOSUXIMIDE DROSPIRENONE-ETHINYL ESTRADIOL- ETHYNODIOL DIACET & ETH ESTRAD LEVOMEFOLATE CALCIUM ETODOLAC Droxia ETONOGESTREL-ETHINYL ESTRADIOL Duaklir Pressair Evamist Duavee EXEMESTANE Duexis Ezallor Sprinkle Dulera EZETIMIBE DULOXETINE HCL EZETIMIBE-SIMVASTATIN Duopa FaLessa Durlaza FAMOTIDINE DUTASTERIDE Farxiga DUTASTERIDE-TAMSULOSIN HCL FEBUXOSTAT Dutoprol FELBAMATE Edarbi FELODIPINE Edarbyclor Femring Elestrin FENOFIBRATE Eliquis FENOFIBRATE MICRONIZED Elixophyllin FENOPROFEN CALCIUM Ella Ferriprox Emgality Fetzima Emsam FEXOFENADINE HCL ENALAPRIL MALEATE Fiasp ENALAPRIL MALEATE & HYDROCHLOROTHIAZIDE Fiasp FlexTouch ENTACAPONE Fiasp PenFill Entresto Fibricor Epaned FINASTERIDE EPLERENONE First - Metoprolol Equetro First-Atenolol Ergoloid Mesylates First-Lansoprazole ESCITALOPRAM OXALATE First-Omeprazole ESOMEPRAZOLE MAGNESIUM FLAVOXATE HCL ESTRADIOL FLECAINIDE ACETATE ESTRADIOL & NORETHINDRONE ACETATE FloLipid 4 This document contains references to brand-name prescription drugs that are trademarks or registered trademarks of pharmaceutical manufacturers not affiliated with Paramount Advantage.
Flovent Diskus Horizant Flovent HFA HumaLOG FLUDROCORTISONE ACETATE HumaLOG Junior FLUOXETINE HCL HumaLOG FluPHENAZine HCl HumaLOG Mix 50/50 FLURBIPROFEN HumaLOG Mix 75/25 FLUTICASONE-SALMETEROL HumuLIN 70/30 FLUVASTATIN SODIUM HumuLIN N FLUVOXAMINE MALEATE HumuLIN R Forfivo XL HumuLIN R U-500 Fosamax Plus D HYDRALAZINE HCL FOSINOPRIL SODIUM HYDROCHLOROTHIAZIDE FOSINOPRIL SODIUM & HYDROCHLOROTHIAZIDE HYDROXYZINE HCL Fosrenol HydrOXYzine HCl FUROSEMIDE HYDROXYZINE PAMOATE GABAPENTIN HydrOXYzine Pamoate Galafold HYOSCYAMINE SULFATE GALANTAMINE HYDROBROMIDE IBANDRONATE SODIUM Galantamine Hydrobromide IBUPROFEN Gelnique IMIPRAMINE HCL GEMFIBROZIL IMIPRAMINE PAMOATE GLIMEPIRIDE Imvexxy Maintenance Pack GLIPIZIDE Imvexxy Starter Pack GLIPIZIDE-METFORMIN HCL Incruse Ellipta GLYBURIDE INDAPAMIDE GLYBURIDE-METFORMIN Indocin Glyxambi INDOMETHACIN Gocovri Ingrezza GoNitro InnoPran XL Gralise Intrarosa Grastek Invokamet GUANFACINE HCL Invokamet XR GUANFACINE HCL (ADHD) Invokana HALOPERIDOL IPRATROPIUM BROMIDE HALOPERIDOL LACTATE IPRATROPIUM BROMIDE (NASAL) Hemangeol IPRATROPIUM-ALBUTEROL Hetlioz IRBESARTAN 5 This document contains references to brand-name prescription drugs that are trademarks or registered trademarks of pharmaceutical manufacturers not affiliated with Paramount Advantage.
IRBESARTAN-HYDROCHLOROTHIAZIDE Latuda ISOSORBIDE DINITRATE LEFLUNOMIDE ISOSORBIDE MONONITRATE LETROZOLE ISRADIPINE LEVALBUTEROL HCL Janumet Levalbuterol Tartrate Janumet XR Levemir Januvia LEVETIRACETAM Jardiance Levobunolol HCl Jentadueto LEVOCARNITINE (METABOLIC MODIFIERS) Jentadueto XR LEVOCETIRIZINE DIHYDROCHLORIDE Juxtapid LEVONORGESTREL-ETHINYL ESTRADIOL Kalydeco LEVOTHYROXINE SODIUM Kapspargo Sprinkle Linzess Katerzia LIOTHYRONINE SODIUM Kazano Lipofen K-Bicarb LISINOPRIL KETONE TEST STRIP, URINE LISINOPRIL & HYDROCHLOROTHIAZIDE Ketoprofen Lithium Ketoprofen ER LITHIUM CARBONATE Kineret Lithostat Klor-Con M15 Livalo Kombiglyze XR Lo Loestrin Fe Korlym Lokelma Kristalose Lonhala Magnair Starter Kit K-Tab LORATADINE LABETALOL HCL LOSARTAN POTASSIUM LACTULOSE LOSARTAN POTASSIUM & HYDROCHLOROTHIAZIDE LAMOTRIGINE LOVASTATIN LANCETS LOXAPINE SUCCINATE Lanoxin Lumify LANSOPRAZOLE Lumigan LANTHANUM CARBONATE Maprotiline HCl Lantus Marplan Lantus SoloStar Meclofenamate Sodium LATANOPROST MEDROXYPROGESTERONE ACETATE Latanoprost MEFENAMIC ACID Latanoprost-Timolol Maleate MELOXICAM 6 This document contains references to brand-name prescription drugs that are trademarks or registered trademarks of pharmaceutical manufacturers not affiliated with Paramount Advantage.
MEMANTINE HCL NATEGLINIDE Menest Nature-Throid Menostar Nefazodone HCl MESALAMINE Nesina Metaproterenol Sulfate Neupro METFORMIN HCL NexIUM METHAZOLAMIDE NIACIN METHIMAZOLE NICARDIPINE HCL METHYLDOPA NIFEDIPINE Methyldopa-Hydrochlorothiazide NIMODIPINE METOLAZONE NISOLDIPINE METOPROLOL & HYDROCHLOROTHIAZIDE Nisoldipine ER METOPROLOL SUCCINATE NITISINONE METOPROLOL TARTRATE Nitro-Bid Mexiletine HCl NITROGLYCERIN MIGLITOL NitroMist MINOXIDIL Nitro-Time MIRTAZAPINE Nityr MISOPROSTOL NIZATIDINE MOEXIPRIL HCL Nizatidine Molindone HCl Nocdurna MONTELUKAST SODIUM ESTRADIOL-FE Motegrity NORETHINDRONE ACETATE Multaq NORETHINDRONE ACETATE-ETHINYL ESTRADIOL Myalept NORETHINDRONE ACETATE-ETHINYL ESTRADIOL-FE Myrbetriq NORGESTIMATE-ETHINYL ESTRADIOL Mytesi NORGESTREL & ETHINYL ESTRADIOL NABUMETONE Norpace CR NADOLOL NORTRIPTYLINE HCL Nalfon Nortriptyline HCl Namzaric Nourianz Naprelan NovoLIN R FlexPen NAPROXEN NovoLOG NAPROXEN SODIUM NovoLOG Mix 70/30 NAPROXEN-ESOMEPRAZOLE MAGNESIUM NovoLOG PenFill Nascobal Nuedexta Natazia Nymalize 7 This document contains references to brand-name prescription drugs that are trademarks or registered trademarks of pharmaceutical manufacturers not affiliated with Paramount Advantage.
Ogestrel PERPHENAZINE OLANZAPINE Perphenazine-Amitriptyline OLANZAPINE-FLUOXETINE HCL Perseris OLMESARTAN MEDOXOMIL Pertzye OLMESARTAN MEDOXOMIL-AMLODIPINE- Pexeva HYDROCHLOROTHIAZIDE PHENELZINE SULFATE OLMESARTAN MEDOXOMIL-HYDROCHLOROTHIAZIDE PHENYTOIN OMEGA-3-ACID ETHYL ESTERS PHENYTOIN SODIUM EXTENDED OMEPRAZOLE Phoslyra OMEPRAZOLE-SODIUM BICARBONATE PILOCARPINE HCL (ORAL) OmniPod 5 Pack Pimozide OmniPod Starter PINDOLOL Onglyza PIOGLITAZONE HCL Oralair PIOGLITAZONE HCL-GLIMEPIRIDE Orfadin PIOGLITAZONE HCL-METFORMIN HCL Orkambi PIROXICAM Oseni Pot Bicarb-Pot Chloride Osmolex ER POTASSIUM BICARBONATE Osphena POTASSIUM CHLORIDE OXAPROZIN POTASSIUM GLUCONATE OXCARBAZEPINE Pradaxa Oxtellar XR Praluent OXYBUTYNIN CHLORIDE PRAMIPEXOLE DIHYDROCHLORIDE Oxytrol PRASUGREL HCL Ozempic PRAVASTATIN SODIUM PALIPERIDONE PRAZOSIN HCL Pancreaze Prefest PANTOPRAZOLE SODIUM Premarin PARICALCITOL Premphase PAROXETINE HCL Prempro PAROXETINE MESYLATE Prestalia Paxil PriLOSEC Peganone PRIMIDONE Pentasa PROBENECID PENTOXIFYLLINE PROCHLORPERAZINE MALEATE Perforomist Procysbi PERINDOPRIL ERBUMINE PROGESTERONE MICRONIZED 8 This document contains references to brand-name prescription drugs that are trademarks or registered trademarks of pharmaceutical manufacturers not affiliated with Paramount Advantage.
PROPAFENONE HCL ROPINIROLE HYDROCHLORIDE PROPRANOLOL HCL ROSUVASTATIN CALCIUM Propranolol HCl Rybelsus Propranolol-HCTZ Rytary PROPYLTHIOURACIL SALSALATE Protonix Saphris PROTRIPTYLINE HCL Savaysa Pulmicort Flexhaler Savella Pump Remote Programmer Saxenda Qbrelis Secuado Qmiiz ODT Seebri Neohaler Qtern Segluromet Qudexy XR SELEGILINE HCL QUETIAPINE FUMARATE Serevent Diskus QUINAPRIL HCL SERTRALINE HCL QUINAPRIL-HYDROCHLOROTHIAZIDE SEVELAMER CARBONATE QUINIDINE GLUCONATE SEVELAMER HCL QuiNIDine Sulfate Signifor Qvar RediHaler Signifor LAR RABEPRAZOLE SODIUM SILODOSIN RALOXIFENE HCL Simbrinza RAMIPRIL SIMVASTATIN RANOLAZINE Slynd RASAGILINE MESYLATE SODIUM FLUORIDE (DENTAL) Rayaldee Sof-serter Insertion Device Relafen DS SOLIFENACIN SUCCINATE REPAGLINIDE Soliqua Repatha Soltamox Restasis SOTALOL HCL Rexulti SOTALOL HCL (AFIB/AFL) Rhopressa Sotylize Ridaura Spiriva HandiHaler RILUZOLE Spiriva Respimat Riomet ER SPIRONOLACTONE RISEDRONATE SODIUM SPIRONOLACTONE & HYDROCHLOROTHIAZIDE RIVASTIGMINE TARTRATE Spritam Rocklatan Stalevo 9 This document contains references to brand-name prescription drugs that are trademarks or registered trademarks of pharmaceutical manufacturers not affiliated with Paramount Advantage.
STANNOUS FLUORIDE Timoptic Ocudose Steglatro Timoptic-XE Steglujan Tirosint Stiolto Respimat Tirosint-SOL Strensiq TOLBUTamide Striverdi Respimat TOLCAPONE SUCRALFATE Tolmetin Sodium SULFASALAZINE TOLTERODINE TARTRATE SULINDAC TOPIRAMATE Symax Duotab Topiramate ER Symbicort TOREMIFENE CITRATE Symdeko TORSEMIDE SymlinPen Toujeo Max SoloStar Synjardy Toujeo SoloStar Synjardy XR Toviaz TAMOXIFEN CITRATE Tradjenta TAMSULOSIN HCL TRANDOLAPRIL Tavalisse TRANDOLAPRIL-VERAPAMIL HCL Taytulla Trandolapril-Verapamil HCl ER Tegsedi TRANYLCYPROMINE SULFATE Tekturna HCT TRAVOPROST TELMISARTAN TRAZODONE HCL TELMISARTAN-AMLODIPINE TraZODone HCl TELMISARTAN-HYDROCHLOROTHIAZIDE Trelegy Ellipta TERAZOSIN HCL Tresiba TERBUTALINE SULFATE TRIAMTERENE Theo-24 TRIAMTERENE & HYDROCHLOROTHIAZIDE THEOPHYLLINE TRIFLUOPERAZINE HCL Theophylline ER Triglide Thiola TRIHEXYPHENIDYL HCL Thiola EC Trikafta THIORIDAZINE HCL TRIMIPRAMINE MALEATE THIOTHIXENE Trintellix THYROID Trokendi XR TIAGABINE HCL TROSPIUM CHLORIDE Tiglutik Trulance TIMOLOL MALEATE Trulicity 10 This document contains references to brand-name prescription drugs that are trademarks or registered trademarks of pharmaceutical manufacturers not affiliated with Paramount Advantage.
Tudorza Pressair Westhroid URSODIOL Xadago Utibron Neohaler Xarelto VALPROATE SODIUM Xelpros VALPROIC ACID Xermelo VALSARTAN Xigduo XR VALSARTAN-HYDROCHLOROTHIAZIDE Xiidra Vascepa Xopenex HFA Vecamyl Xulane Velphoro Xultophy Veltassa Xuriden VENLAFAXINE HCL Yosprala VERAPAMIL HCL Yupelri Verapamil HCl ER ZAFIRLUKAST Verelan Zelapar Verelan PM Zenpep Victoza ZILEUTON Viibryd Zioptan Viibryd Starter Pack ZIPRASIDONE HCL Viokace ZONISAMIDE Vivlodex Zontivity Vraylar Zorvolex Vyzulta Zyflo WARFARIN SODIUM Zypitamag
11 This document contains references to brand-name prescription drugs that are trademarks or registered trademarks of pharmaceutical manufacturers not affiliated with Paramount Advantage.