ACA HDHP Preventive Care Drug List

Preventive care can help keep you healthy and may even save your life. Getting routine health exams and screenings can help catch problems early, when they’re easier to treat. And getting the right preventive care services can help you manage your health conditions and stay healthy. Under the Affordable Care Act (ACA), pharmacy benefits must cover certain categories of preventive care drugs and products at 100%. That means you don’t have to pay a share of the cost — no copay, deductible or percentage of the cost (coinsurance). How do I get these drugs at no cost? Talk with your doctor about choosing the medication or product that’s right for you. To get these preventive drugs, including over-the-counter (OTC) drugs or products: 1 They must be right for your age and condition. 1 You’ll need to get a prescription from your doctor (even for OTC products). 1 Remember, only you and your doctor can decide on the medications you need and what’s best for your health. Preventive drugs and products, by category Here’s a list of medications Anthem plans will cover with no cost-share for you under the ACA. Keep in mind that this list can change. Brand-name drugs are listed with a first capital letter. Non-brand drugs (generics) are in lowercase letters. ASPIRIN Coverage includes generic over-the- counter 81mg and 325mg aspirin products to prevent preeclampsia in pregnant women and to prevent cardiovascular disease and colorectal cancer in adults 60-69 years old. Aspirin 81mg, 325mg (tab, ec tab, chew) BOWEL PREP Coverage includes generic prescription and over-the-counter products and are limited to two (2) bowel prep kits per year for adults 50 - 75 years old. bisacodyl bisacodyl-peg 3350-pot chloride-sod bicarb- sod chloride magnesium citrate, hydroxide peg 3350-potassium chloride-sod bicarbonate-sod chloride (generic Nulytely) peg 3350-kcl-sod bicarb-sod chloride- sod sulfate (generic Golytely) peg 3350-kcl-nacl-na sulfate-na ascorbate- ascorbic acid (generic Moviprep) polyethylene glycol 3350 BREAST CANCER You may be required to get preapproval for the services associated with the drugs in this category anastrozole 1mg exemestane 25mg letrozole 2.5 mg raloxifene 60mg Soltamox tamoxifen 10mg, 20mg CARDIOVASULAR Full coverage for low-to- moderate dose generic statins will be limited to members 40-75 years old with one or more cardiovascular risk factor such as dyslipidemia, diabetes, hypertension, or smoking but who have not experienced a cardiovascular disease event. atorvastatin (10 - 20 mg) fluvastatin (20 - 80 mg) lovastatin (10 - 40mg) pravastatin (10 - 80mg) rosuvastatin (5 - 10mg) simvastatin (5 - 40mg) CONTRACEPTION This benefit also applies to those younger than age 19. A cost share may apply for other prescription contraceptives, based on your drug benefits. Your cost share may be waived if your doctor decides that using the multisource brand is medically necessary. Oral Contraceptives afirmelle 0.1-0.02 altavera alyacen 7/7/7 amethia amethia lo amethyst 90-20mcg apri aranelle ashlyna aubra 0.1-0.02 aubra eq 0.1-0.02 aurovela 1.5/30 aurovela 1/20 aurovela 24 fe 1/20 aurovela fe 1.5/30 aurovela fe 1/20 aviane ayuna azurette 28 balziva bekyree blisovi 24 fe 1/20 blisovi fe 1.5/30 blisovi fe 1/20 briellyn camila 0.35mg camrese camrese lo caziant chateal 0.15/30 chateal eq 0.15/30 cryselle-28 cyclafem 1/35 cyclafem 7/7/7 cyred cyred eq dasetta 1/35 dasetta 7/7/7 daysee deblitane 0.35mg delyla 0.1-0.02 deso/ethinyl estradio dros/eth est levomefo drospir/ethi 3-0.03mg drospire/eth/estr/lev drospirenone ethy est elinest emoquette enpresse-28 enskyce errin 0.35mg estarylla 0.25-35 ethy eth est 1-35 ethynodiol 1-50 falmina fayosim femynor 0.25-35 gianvi 3-0.02mg hailey 1.5/30 hailey 24 fe heather 0.35mg incassia 0.35mg introvale isibloom isibloom 0.15-30 jaimiess jasmiel 3-0.02mg jencycla 0.35mg jolessa jolivette 0.35mg juleber ACA Preventive Care Drug List