Changes in Prescription Drug Coverage

Two major carriers have announced a list of drugs that will no longer be covered under their private prescription plans.  The two carriers are

  • Caremark and
  • Express Scripts

These two companies together provides prescription coverage for more than 200 million Americans.  Other carriers are expected to take similar actions.

Please note, these companies provide Medicare prescription coverage, and the treatment of the drugs below may be different.

What you need to do.

Please read the list below and see if any drugs that you now take are on the list.  Then . . .

(1) Check with your insurer to make sure the drug is no longer covered under your plan.  If it has been dropped . . . 

(2) Talk to your pharmacist about whether there are generic drugs or other similar drugs that you could use instead of a listed drug.  If there is an opportunity to make a change . . . 

(3) Talk to your doctor.  He’ll have to write a new script for you in any case. If you still need a listed drug . . .

(4) See of there is a pharmacy discount card that can save you some money.  If a drug is no longer covered, you would be paying full retail price, and that could be quite expensive.  Any discount is better than nothing.  (Personally, I carry the GoodRx card. It’s free.  However, for some drugs, the pharmacist may be able to help with a discount.)

And remember: Your Congressman is responsible for the exorbitant prices paid for drugs in the US, which is anywhere from 4 times to 17+ times what citizens of other countries pay for the same products.  Bills to lower prices for some drugs failed in December and January in the face of opposition from GOP leadership.

Here’s the list of drugs being dropped.

Abilify (Caremark)
Abstral (Caremark)
Alcortin A (Caremark)
All non-BD pen needles and syringes (Caremark)
Aloquin (Caremark)
butalbital/acetaminophen/caffeine capsules (Caremark)
Carnitor (Caremark)
Carnitor SF (Caremark)
Colchicine (Express Scripts)
Crestor (Caremark)
Daklinza (Caremark)
Dexpak (Caremark)
Dutoprol (Caremark)
Effexor XR (Caremark)
Enablex (Caremark)
Evzio (Caremark)
Fioricet capsules (Caremark)
Gelnique (Caremark)
Gleevec (Caremark)
Helixate FS (Caremark)
Kineret (Express Scripts)
Klor-Con packets (Caremark)
Lantus (Caremark)
Millipred (Caremark)
Millipred DP (Caremark)
Neupogen (Caremark)
Nexium (Caremark)
Nilandron (Caremark)
Novacort (Caremark)
Olysio (Caremark)
Opsumit (Caremark)
Orencia (Express Scripts)
Pradaxa (Caremark)
Proventil HFA (Caremark)
Taltz (Express Scripts)
Tasigna (Caremark)
Technivie (Caremark)
Tobi (Caremark)
Toujeo (Caremark)
venlafaxine ER (except tablet) (Caremark)
Ventolin HFA (Caremark)
Xenazine (Caremark)
Xtandi (Caremark)
Zebutal capsules (Caremark)
Zegerid (Caremark)
Zepatier (Caremark)
Zyclara (Express Scripts)

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