February 23, 2006 Dear Prescription Advantage Member: This letter is to inform you about changes to your Prescription Advantage coverage because of the new Medicare prescription drug coverage that began on January 1, 2006. Since this drug coverage will be available, Prescription Advantage will provide supplemental coverage for prescription drug purchases of members who are eligible for Medicare. For all members, with or without Medicare, Prescription Advantage will only cover classes of drugs that Medicare has not excluded from coverage. We have determined that you have taken one or more of the prescription drugs listed on the second page of this letter, which Medicare has excluded from coverage. As of March 31, 2006, Prescription Advantage will no longer cover these drugs. We recommend that you speak to your doctor regarding this change in drug coverage as he or she can most appropriately advise you of any viable alternatives or substitutions that are available to you. Your doctor is the most qualified person to determine which prescription drugs are suitable for you. If you have any questions, please call Customer Service (toll free) at 1-800-AGE-INFO (1-800- 243-4636) or TTY for the deaf and hard of hearing at 1-877-610-0241. Sincerely, Prescription Advantage Commonwealth of Massachusetts Executive Office of Health and Human Services Executive Office of Elder Affairs Prescription Advantage 1-800-AGE-INFO (1-800-243-4636) TTY: 1-877-610-0241 www.800ageinfo.com 3/9/2006 Page 2 of 3 Alkabel-sr tablet Fioricet tablet Phenazopyridine plus Amibid dm tablet sa Fiorinal capsule Phenobarbital Antispasmodic elixir Folbalin tablet Phenylhistine dh liquid Apap/butalbital 325/50 tab Folbee plus tablet Phrenilin tablet Ascomp w/codeine capsule Folbic tablet Poly-iron 150 forte Avage 0.1% cream Folcaps tablet Proferrin-forte tablet B-complex vitamin plus Folgard rx 2.2 tablet Promethazine w/dm Promethazine/codeine Belladonna/phenobarb elixir Folic acid syrup Bellamine-s tablet Folitab 500 caplet Propecia 1 mg tablet Bellatal er tablet Folplex 2.2 tablet Protect plus nr softgel Benoquin 20% cream Foltrin capsule Pyridium plus tablet Benzonatate 100 mg Foltx tablet Renal caps softgel Biotussin ac syrup Fortabs tablet Renaphro softgel Botox 100 units vial Gani-tuss nr liquid Renax caplet Brometane dx syrup Gfn 1,000/dm 60 tab Renova 0.02% cream Bromplex hd liquid Guaifenesin Repan tablet Btrex tablet Guaifenex dm tablet sa Repliva 21/7 tablet Butalbital Gual-co liquid Robafen ac syrup Butisol sodium Guiatuss ac syrup Solage topical solution Cefol filmtab H-c tussive syrup Strovite tablet Cerefolin tablet Hemax sr caplet Su-tuss hd elixir Certuss-d tablet Histinex hc syrup Tannate 12 s susp Cheratussin ac syrup Humibid dm capsule Therobec plus tablet Chromagen Hycodan syrup Touro cc caplet sa Clidinium/cdp capsule Hydrocodone compound syrup Touro dm tablet sa Codal-dh syrup Hydrocodone/guaifenesin syr Tretinoin 0.05% cream Codituss dh syrup Hydrocodone/homatropine tab Tri-luma cream Combgen tablet Hydromet syrup Trinsicon capsule Conison capsule Hydroquinone 3% solution Tussi-12 tablet C-tanna 12 suspension Iophen-c nr liquid Tussi-12d tablet Cyanocobalamin Librax capsule Tussionex pennkinetic susp Dexfol tablet Marten-tab 325/50 tablet Tussi-organidin nr liquid Dialyvite 3,000 tablet Mebaral Uni-daily tablet Diatx tablet Meridia 10 mg capsule Urelief plus tablet Diatx zn tablet Metanx tablet Vaniqa 13.9% cream Donnatal Muco-fen dm tablet sa V-c forte capsule Drisdol Multi-ret folic 500 tablet Vi-q-tuss syrup Eperbel-s tablets Mytussin ac syrup Vitacon forte capsule Esgic Mytussin dac syrup Vitamin D capsule Fa-cyancoba-pyridoxine tab Nascobal nasal gel Vitaplex tablet Farbital capsule Nephplex rx tablet Xenical 120 mg capsule Feogen capsule Nephrocaps capsule Feogen forte softgel Niaspan Ferocon capsule Nicomide tablet Ferrex 150 forte capsule Niferex-150 forte capsule Ferrous sulfate 325 mg tab Nufol tablet Commonwealth of Massachusetts Executive Office of Health and Human Services Executive Office of Elder Affairs Prescription Advantage 1-800-AGE-INFO (1-800-243-4636) TTY: 1-877-610-0241 www.800ageinfo.com 3/9/2006 Page 3 of 3 .