Preventive Medications List (Lista de medicinas preventivas) Current (Corriente) 7/1/21 NOTE: Coverage for preventive services are subject to the member’s benefit terms, limitations and maximums
ASPIRIN (ASPIRINA) aspirin 81 mg (OTC)
BOWEL PREP AGENTS (PREPARACIÓN INTESTINAL) polyethylene glycol 3350 with electrolytes oral solution
BREAST CANCER PREVENTION (PREVENCIÓN DEL CÁNCER DE SENO) anastrozole tabs raloxifene tabs tamoxifen tabs
CONTRACEPTIVES (ANTICONCEPTIVOS) A listing of current covered contraceptives can be found here (Una lista de anticonceptivos cubiertos actuales pueden encontrarse aquí)
FLUORIDE SUPPLEMENTS (limited 6 months to 6 years of age) (SUPLEMENTOS DE FLUORURO – uso limitado desde los 6 meses hasta los 6 años de edad) sodium fluoride chew tabs; cream; drops; gel; oral rinse; paste; soln sodium fluoride/potassium nitrate paste stannous fluoride gel
FOLIC ACID SUPPLEMENTS (SUPLEMENTOS DE ÁCIDO FÓLICO – solo mujeres) folic acid tabs (OTC), 400 mcg, 800 mcg
HIV PRE-EXPOSURE PROPHYLAXIS (PrEP) emtricitabine/tenofovir disoproxil fumarate 200-300 mg tenofovir disoproxil fumarate
IRON SUPPLEMENTS (members under 12 months of age only) (SUPLEMENTOS DE HIERRO – miembros menores a los 12 meses de edad solamente) ferrous sulfate elixir, drops
STATINS (ESTATINAS) lovastatin 20, 40 mg pravastatin
TOBACCO CESSATION (PROGRAMA PARA DEJAR DE FUMAR) bupropion extended-release (generic indicated for smoking cessation) CHANTIX nicotine gum (generic) nicotine lozenge (generic) nicotine patch (generic) NICOTROL INHALER NICOTROL NASAL SPRAY
VACCINES (VACUNAS) A listing of current covered vaccines can be found here (Una lista de vacunas cubiertas actuales pueden encontrarse aquí)
Generics = lower case Brands = CAPITAL LETTERS (Genéricos = letra minúscula Marca= LETRAS MAYÚSCULA)
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