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Preventive Medication Program

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Preventive Medication Program PREVENTIVE MEDICATION PROGRAM Generics and Preferred Brands Drug List Starting July 1, 2021 Preventive medications are used to prevent certain conditions from developing, or to prevent a condition from coming back. These conditions include, but are not limited to, asthma, depression, diabetes, heart attack, high blood pressure, high cholesterol, osteoporosis, prenatal nutrient deficiency and stroke. About this drug list. Your cost-share for preventive generic and This is a list of the most commonly prescribed generic preferred brand medications. and preferred brand medications that are part of Not all plans offer the same cost-share for their Cigna’s preventive medication program as of July preventive medication program. For example, some 1, 2021.1,2 This drug list is updated often so it isn’t a plans may require you to pay a copay, coinsurance complete list of medications. Also, your specific plan’s and/or deductible for preventive generic and preferred preventive medication program may not include all brand medications; other plans may not. of these medications and/or conditions. Log in to the Log into the myCigna App or myCigna.com and use myCigna® App or myCigna.com, or check your plan the Price a Medication tool to see how much your materials, to see all of the medications included in your medication may cost you at the different pharmacies in plan’s preventive medication program and how much your plan’s network.3 they cost. Here’s some helpful information about this drug list: › Medications are listed alphabetically by condition. › Brand-name medications are capitalized and generic medications are lowercase. Most brand-name medications that have a generic equivalent are no longer part of Cigna’s preventive medication program. Go generic and save. › This drug list doesn’t include preventive medications that are covered at 100%, or no cost-share ($0) to Ask your doctor if a preventive generic you, under the Patient Protection and Affordable Care medication may be right for you. Generics Act (PPACA)’s preventive services coverage have the same strength and active requirement. ingredients as brand-name medications, but often cost much less – in some cases, up to 85% less.4 Offered by: Cigna Health and Life Insurance Company, Connecticut General Life Insurance Company, or their affiliates. 951740 a Gen&PB for Legacy 09/21 Preventive Medication Program - Generics and Preferred Brands Drug List Anxiety/Depression/ Blood Pressure Related irbesartan irbesartan-HCTZ Bipolar Disorder acebutolol isradipine citalopram acetazolamide tablet labetalol tablet escitalopram acetazolamide ER lisinopril fluoxetine afeditab CR lisinopril-HCTZ fluoxetine DR aliskiren losartan fluvoxamine amiloride losartan-HCTZ fluvoxamine ER amiloride-HCTZ matzim LA paroxetine amlodipine methazolamide paroxetine CR amlodipine-benazepril methyldopa paroxetine ER amlodipine-olmesartan methyldopa-HCTZ sertraline amlodipine-valsartan metolazone amlodipine-valsartan-HCTZ metoprolol tablet Asthma Related atenolol metoprolol ER Advair HFA atenolol-chlorthalidone Metoprolol ER-HCTZ albuterol benazepril metoprolol-HCTZ albuterol HFA benazepril-HCTZ metyrosine Anoro Ellipta betaxolol tablet minoxidil tablet Asmanex bisoprolol moexipril Asmanex HFA bisoprolol-HCTZ moexipril-HCTZ Atrovent HFA bumetanide tablet nadolol Bevespi Aerosphere Bystolic nadolol-bendroflumethiazide Breo Ellipta candesartan nicardipine capsule budesonide suspension candesartan-HCTZ nifedipine caffeine citrate oral solution captopril nifedipine ER Combivent Respimat captopril-HCTZ nimodipine cromolyn nebulizer solution Cartia XT nisoldipine Dulera carvedilol olmesartan Flovent Diskus carvedilol ER olmesartan-HCTZ Flovent HFA chlorothiazide olmesartan-amlodipine-HCTZ fluticasone-salmeterol chlorthalidone perindopril Incruse Ellipta clonidine patch, tablet phenoxybenzamine ipratropium solution diltiazem pindolol ipratropium-albuterol diltiazem ER prazosin levalbuterol dilt-XR propranolol tablet, solution levalbuterol concentrate Diuril propranolol ER Levalbuterol HFA doxazosin propranolol-HCTZ metaproterenol enalapril quinapril montelukast enalapril-HCTZ quinapril-HCTZ Pulmicort Flexhaler eplerenone ramipril QVAR RediHaler eprosartan sorine Serevent Diskus felodipine ER sotalol tablet Symbicort fosinopril sotalol AF terbutaline tablet fosinopril-HCTZ spironolactone Theo-24 furosemide tablet, solution spironolactone-HCTZ theophylline tablet, solution guanfacine taztia XT wixela inhub hydralazine tablet Tekturna HCT zafirlukast hydrochlorothiazide telmisartan zileuton ER indapamide Brand-name medications are capitalized and generic medications are lowercase. Some plans may not consider these conditions and medications to be part of their preventive medication coverage. Log in to the myCigna App or myCigna.com, or check your plan materials, to see all of the medications included in your plan’s preventive medication program and how much they cost. 2 Blood Pressure Related omega-3 acid ethyl esters nateglinide (continued) pravastatin Novolin prevalite Novolog telmisartan-HCTZ rosuvastatin Ozempic telmisartan-amlodipine pioglitazone terazosin simvastatin tablet pioglitazone-glimepiride tiadylt ER triklo pioglitazone-metformin timolol tablet Vascepa QTERN torsemide Diabetes Related repaglinide trandolapril repaglinide-metformin trandolapril-verapamil ER Log in to the myCigna App or Rybelsus triamterene myCigna.com, or check your plan Segluromet triamterene-HCTZ materials, to learn more about how Soliqua valsartan your plan covers diabetes-related Steglatro valsartan-HCTZ preventive medications. SymlinPen Vecamyl acarbose Synjardy verapamil tablet, capsule alogliptin Synjardy XR verapamil ER alogliptin-metformin tolazamide verapamil ER PM alogliptin-pioglitazone tolbutamide Basaglar Tresiba Blood Thinner Related Bydureon Trijardy XR aspirin-dipyridamole ER Byetta Trulicity Brilinta chlorpropamide Victoza cilostazol Diabetic Supplies (i.e. lancets, Xigduo XR clopidogrel syringes, urine test, alcohol pads) Xultophy dipyridamole tablet Farxiga Fiasp *Only certain formulations of metformin ER 500mg are Eliquis considered preventive. Log in to the myCigna App or glimepiride Jantoven myCigna.com to see which ones are included in your plan’s prasugrel glipizide preventive medication program. ticlopidine glipizide ER warfarin glipizide XL Osteoporosis Related glipizide-metformin Xarelto alendronate glyburide calcitonin-salmon glyburide micronized Cholesterol Related Forteo glyburide-metformin amlodipine-atorvastatin ibandronate tablet Glyxambi atorvastatin Miacalcin Humalog cholestyramine raloxifene Humulin risedronate cholestyramine light Insulin Aspart risedronate DR colesevelam Insulin Lispro Tymlos Colestid Invokamet colestipol Invokamet XR Prenatal Vitamins ezetimibe Invokana ezetimibe-simvastatin Janumet Your plan considers all prescription fenofibric acid Janumet XR strength prenatal vitamins to be fluvastatin Januvia “preventive.” fluvastatin ER Jardiance Log in to the myCigna App or gemfibrozil Levemir myCigna.com to see which tier icosapent ethyl Lyumjev your plan covers prenatal vitamins lovastatin metformin on. niacin 500mg tablet metformin ER 500mg tablet* metformin ER 750mg tablet niacin ER tablet miglitol Niacor Brand-name medications are capitalized and generic medications are lowercase. Some plans may not consider these conditions and medications to be part of their preventive medication coverage. Log in to the myCigna App or myCigna.com, or check your plan materials, to see all of the medications included in your plan’s preventive medication program and how much they cost. 3 1. State laws in Texas and Louisiana may require your plan to cover your medication at your current benefit level until your plan renews. This means that if your medication is taken off the drug list, is moved to a higher cost-share tier or needs approval from Cigna before your plan will cover it, these changes may not begin until your plan’s renewal date. To find out if these state laws apply to your plan, please call Customer Service using the number on your Cigna ID card. 2. State law in Illinois may require your plan to cover your medications at your current benefit level until your plan renews. This means that if you currently have approval through a review process for your plan to cover your medication, the drug list change(s) listed here may not affect you until your plan renewal date. If you don’t currently have approval through a coverage review process, you may continue to receive coverage at your current benefit level if your doctor requests it. To find out if this state law applies to your plan, please call Customer Service using the number on your Cigna ID card. 3. Prices shown on myCigna are not guaranteed and coverage is subject to your plan terms and conditions. Visit myCigna for more information. 4. U.S. Food and Drug Administration (FDA) website, “Generic Drug Facts.” Last updated 06/01/18. Cigna reserves the right to make changes to this drug list without notice. Your plan may cover additional medications; please refer to your enrollment materials for details. Cigna does not take responsibility for any medication decisions made by the doctor or pharmacist. Cigna may receive payments from manufacturers of certain preferred brand medications, and in limited instances, certain non-preferred brand medications, that may or may not be shared with your plan depending on its arrangement with Cigna. Depending upon plan design, market conditions, the extent to which manufacturer payments are shared with your plan
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