Prmtcdhcapdl-12.anp-pdl.11100

2012 Express Scripts National Preferred
Preventive Drug List
Prescription Drugs: You Make the Choices, We Make it Easy
Preventive Prescription Drugs: A Good Choice
Prescription drugs that can help keep you from developing a health condition are cal ed preventive prescription drugs. They can help you maintain your quality of life and avoid
expensive treatment, helping to reduce your overal healthcare costs.
If your doctor prescribes a preventive prescription drug, you pay only a percentage of the total cost – right from the beginning.
Is Your Drug a Preventive Prescription Drug?
The fol owing is a list of the most commonly prescribed preventive drugs. The list is not al -inclusive and does not guarantee coverage. Not al the drugs listed are covered by al
prescription-drug benefit programs; check your benefit materials for the specific drugs covered and the copayment information for your prescription-drug benefit program.
For the member: Generic drugs are listed in lower case letters. Example: atenolol. Generic medications contain the same active ingredients as their corresponding brand-name
medications, although they may look different in color or shape. They have been FDA-approved under strict standards.
Brand-name drugs are listed in CAPITAL letters. Example: TENORMIN. In addition to using this list, you are encouraged to ask your doctor to prescribe generic drugs whenever appropriate.
Some drugs are marked with a symbol “*”. The symbol * next to a drug signifies subject to nonpreferred status when generic is available throughout the year.
For the physician: Please prescribe preferred (Best Buy) products and al ow generic substitutions when medical y appropriate. Thank you.
NOTE: This list does not indicate coverage. You or your doctor may be asked to prove that the drug you're taking is being used for prevention. This list does not include
al conditions that may be prevented with preventive prescription drugs or al preventive drugs available. Your plan sponsor believes that these drugs satisfy the
requirements for preventive care as outlined by the U.S. Treasury Department but cannot ensure that the Treasury Department would agree that al of these drugs satisfy
the definition of preventive care.
BEST BUY MEDICATIONS
The fol owing list of drugs represents the preferred medications under the Preventive care list. Preferred medications are generic or brand-name drugs available to members at the lower cost.
THIS DOCUMENT LIST IS EFFECTIVE JANUARY 1, 2012 THROUGH DECEMBER 31, 2012. THIS LIST IS SUBJECT TO CHANGE.
Check your benefit materials for copayment information. Copayments vary based on formulary status.
For specific questions about your coverage, please cal the phone number printed on your ID card.
You can get more information and updates to this document at our website at www.express-scripts.com.
2012 Express Scripts, Inc.
PRMTCDHCAPDL-12 (10/01/11)
Al Rights Reserved
OTHER PREVENTIVE MEDICATIONS
The fol owing section lists the nonpreferred medications. These are drugs that are available to the member at a higher cost.
THIS DOCUMENT LIST IS EFFECTIVE JANUARY 1, 2012 THROUGH DECEMBER 31, 2012. THIS LIST IS SUBJECT TO CHANGE.
Check your benefit materials for copayment information. Copayments vary based on formulary status.
For specific questions about your coverage, please cal the phone number printed on your ID card.
You can get more information and updates to this document at our website at www.express-scripts.com.
2012 Express Scripts, Inc.
PRMTCDHCAPDL-12 (10/01/11)
Al Rights Reserved

Source: http://graphics.ckmarket.com/G_Employment/Preventative_List.pdf