Latest Newsletters - Notables

Fall 2002

Additional Updates

Exclusions to Your Dean Health Plan Drug Benefit

Our drug benefit does not automatically cover every new drug that the U.S. Food and Drug Administration approves. We have a panel of physicians from many different specialties to evaluate new drugs. If an excluded drug has been prescribed for you, ask your physician or pharmacist if he or she can substitute it for one of the medications we cover. Please call Customer Service for an updated list or for more information about your prescription drug benefit. The following drugs are not covered by Dean Health Plan:

A
Acarbose (PRECOSE)
Acrivastine/pseudoephedrine (SEMPREX-D)
Alosetron (LOTRONEX)
Ardeparin (NORMIFLO)
Appetite suppressants
APRI
AVIANE
Azelastine hydrochloride ophthalmic solution (OPTIVAR)

B
Bepridil (VASCOR)
BIAXIN XL
Bitolterol inhaler (TORNALATE)
BRONTEX (Guaifenesin/codeine)
Butorphanol nasal spray (STADOL NS)

C
Candesartan (ATACAND)
Cefaclor
Cefixime tablets (SUPRAX)
Cefprozil tablets (CEFZIL)
Ceftibuten (CEDAX)
Celicoxib (CELEBREX)
CENESTIN (synthetic conjugated estrogens)
Cephradine
Cerivastatin (BAYCOL)
COVERA-HS
CYCLESSA

D
D.A. II
Dalteparin (FRAGMIN)
Desogestrel Ethinyl Estradiol (ORTHO-CEPT) Excluded 9/1/02
Dexamethasone inhaler (DECADRON TURBINAIRE)
Diclofenac/Misoprostol (ARTHROTEC)
Diclofenac potassium (CATAFLAM)
Diflunisol
Diltiazem HCI (CARDIZEM CD)
Diltiazem SR (DILACOR XR)
Dipyridamole/Aspirin (AGGRENOX)
Dirithromycin (DYNABAC)
DYAZIDE

E
EC-NAPROSYN or NAPRELAN
Eflornithine (VANIQA)
Emadastine diflumarate (EMADINE)
Enalapril/felodipine (LEXXEL)
Enoxacin (PENETREX)
Estradiol/norethindrone transdermal system (COMBIPATCH)
Ethinyl estradiol/noreth AC (FemHRT)
Ethynodiol-mestranol (OVULEN)
Etodolac

F
Famciclovir (FAMVIR)
Famotidine (PEPCID) except generic 20 mg and 40 mg tablets
Fenofibrate (LIPIDIL)
Fenoprofen
Fexofenadine hydrochloride (ALLEGRA)
Fexofenadine/pseudoephedrine (ALLEGRA D)
Flunisolide nasal inhaler (NASALIDE, NASAREL)
Flunisolide oral inhaler (AEROBID, AEROBID-M)
Fluoxetine HCl (tablets)
Flurbiprofen
Fluticasone nasal inhaler (FLONASE AQ)
Fosfomycin (MONUROL)
Fosinopril (MONOPRIL)

G
Gatifloxacin (TEQUIN)

H
HELIDAC

I
Ibuprofen/hydrocodone (VICOPROFEN)
Irbesartan (AVAPRO)
Isoproterenol inhaler (MEDIHALER-ISO or ISUPREL)
Isosorbide mononitrate (ISMO)
Isradipine (DYNACIRC CR)

J
JENSET-28

K
Ketoprofen
Ketotifen fumarate ophthalmic solution (ZADITOR)

L
Levalbuterol (XOPENEX)
LEVLITE
Levofloxacin (LEVAQUIN)
Levonorgestrel Ethinyl Estradiol (NORDETTE) Excluded 9/1/02
LEVORA
LODINE XL
Lomefloxacin (MAXAQUIN)
Loracarbef capsules (LORABID)
Loratadine melting tablets (CLARITIN REDITABS) (Ages > 6)

M
Mefenamic acid (PONSTEL)
Metaproterenol Inhaler (ALUPENT INHALER)
MICORGESTIN FE
MODICON
Minoxidil topical solution (ROGAINE)

N
Naphazoline/antazoline ophthalmic solution
Naphazoline HCL/pheniramine maleate ophthalmic solution
NAPROSYN EC
NECON
Nicardipine (CARDENE and CARDENE SR)
Nifedipine (PROCARDIA XL)
Nisoldipine (SULAR)
Nizatidine (AXID)
Norethindrone Acetate Ethinyl Estradiol (LOESTRIN) Excluded 9/1/02
Norethindrone Ethinyl Estradiol (MODICON) Excluded 9/1/02
NOVOLIN 70/30
NOVOLIN L
NOVOLIN N
NOVOLIN R

O
Ogestrel
Omeprazole (PRILOSEC)
Over-the-counter drugs
Oxaprozin (DAYPRO)

P
Pemirolast potassium ophthalmic solution (ALAMAST)
Phenylpropanolamine-containing products
Phenytoin (all generics)
Pravastatin (PRAVACHOL)
Progesterone—oral (other than PROMETRIUM, which requires prior authorization)
PROPECIA

Q
Quinapril (ACCUPRIL)

R
Rabeprazole (ACIPHEX)
Ramipril (ALTACE)
Ranitidine capsules

S
Sildenafil (VIAGRA)
Smoking cessation products
Sparfloxacin (ZAGAM)

T
Tacrine (COGNEX)
Telmisartan (MICARDIS)
Terbutaline inhaler (BRETHAIRE)
Tiludronate (SKELID)
Tinzaparin (INNOHEP)
Tolmetin
Toremifene (FARESTON)
Torsemide (DEMADEX)
Trandolapril (MAVIK)
Trandolapril/verapamil (TARKA)
Tramadol (ULTRAM) Excluded 9/1/02
Triamcinolone nasal inhaler (NASACORT)
TRILEVLEN
TRITEC
Troglitazone (REZULIN)
Trovafloxacin (TROVAN)

U
Unoprostone isopropyl (RESCULA)

V
Verapamil HCl (VERELAN)
VOLTAREN XR

Y
YASMIN

Z
Zaleplon (SONATA)
Zanamivir (RELENZA)
Zileuton (ZYFLO)
ZOVIA

Please note: Some members may have coverage for one of these drugs based on an exception in their pharmacy benefit or an authorization from Dean Health Plan.

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