| Abilify tablet | No longer covered | aripiprazole tablet |
| Abilify Mycite tablet with sensor | No longer covered | Consult doctor |
| Acanya gel with pump | No longer covered | Consult doctor |
| Aczone gel with pump | No longer covered | dapsone gel |
| Adcirca tablet | No longer covered | tadalafil tablet |
| Adderall tablet | No longer covered | dextroamphetamine/amphetamine tablet |
| Admelog Solostar insulin pen | No longer covered | Novolog pen |
| Akynzeo capsule | No longer covered | Consult doctor |
| Ala-Cort cream | No longer covered | hydrocortisone cream |
| Alogliptin tablet | No longer covered | Consult doctor |
| Ambien tablet | No longer covered | zolpidem tablet |
| Ambien CR extended-release tablet | No longer covered | zolpidem extended-release tablet |
| Ampyra extended-release tablet | No longer covered | dalfampridine extended-release tablet |
| Apadaz tablet | No longer covered | Consult doctor |
| Apexicon E cream | No longer covered | triamcinolone cream |
| Aubagio tablet | No longer covered | Consult doctor |
| Azelex cream | No longer covered | azelaic acid gel |
| Baraclude solution | No longer covered | Consult doctor |
| Baraclude tablet | No longer covered | entecavir tablet |
| Benzefoam foam | No longer covered | benzoyl peroxide topical |
| Benzefoam ultra foam | No longer covered | benzoyl peroxide topical |
| Benzhydrocodone-acetaminophen tablet | No longer covered | Consult doctor |
| Bryhali lotion | No longer covered | halobetasol propionate cream |
| calcipotriene-betamethasone dipropionate ointment | No longer covered | Consult doctor |
| Capex shampoo | No longer covered | clobetasol shampoo |
| Cleansing wash cleanser | No longer covered | sulfacetamide sodium-sulfur topical |
| clindamycin phosphate foam | No longer covered | clindamycin phosphate solution |
| clindamycin phosphate-tretinoin gel | No longer covered | Consult doctor |
| clindamycin-benzoyl peroxide gel with pump | No longer covered | Consult doctor |
| Clobex shampoo | No longer covered | clobetasol shampoo |
| Clobex spray | No longer covered | clobetasol spray |
| Clocortolone pivalate cream | No longer covered | triamcinolone cream |
| Cloderm cream | No longer covered | triamcinolone cream |
| Coremino extended-release tablet | No longer covered | minocycline capsule |
| Cuprimine capsule | No longer covered | penicillamine capsule |
| Cymbalta capsule | No longer covered | duloxetine capsule |
| Delstrigo tablet | No longer covered | Consult doctor |
| Desonate gel | No longer covered | desonide ointment |
| Diclosaicin solution and cream | No longer covered | Consult doctor |
| diflorasone diacetate cream | No longer covered | triamcinolone cream |
| diflorasone diacetate ointment | No longer covered | triamcinolone ointment |
| Ecoza foam | No longer covered | econazole nitrate cream |
| Effexor XR extended-release capsule | No longer covered | venlafaxine extended-release capsule |
| Elidel cream | No longer covered | pimecrolimus cream |
| Emend capsule | No longer covered | aprepitant capsule |
| Emend suspension | No longer covered | Consult doctor |
| esomeprazole magnesium capsule | No longer covered | omeprazole capsule |
| Evenity syringe | No longer covered | Consult doctor |
| Evoclin foam | No longer covered | clindamycin phosphate foam |
| Exelderm cream | No longer covered | ketoconazole cream |
| Exelderm solution | No longer covered | ketoconazole cream |
| Exjade dispersible tablet | No longer covered | deferasirox dispersible tablet |
| Extina foam | No longer covered | ketoconazole cream |
| Ezallor sprinkle capsule | No longer covered | rosuvastatin tablet |
| flunisolide spray aerosol | No longer covered | fluticasone spray aerosol |
| flurandrenolide cream | No longer covered | triamcinolone cream |
| flurandrenolide lotion | No longer covered | triamcinolone lotion |
| flurandrenolide ointment | No longer covered | triamcinolone ointment |
| Focalin tablet | No longer covered | dexmethylphenidate tablet |
| Focalin XR extended-release capsule | No longer covered | dexmethylphenidate extended-release capsule |
| Ganirelix acetate syringe [brand] | No longer covered | ganirelix acetate syringe [generic] |
| Gleevec tablet | No longer covered | imatinib tablet |
| Glucotrol tablet | No longer covered | glipizide tablet |
| Glucotrol XL extended-release tablet | No longer covered | glipizide extended-release tablet |
| Ingrezza capsule | No longer covered | Consult doctor |
| Intuniv extended-release tablet | No longer covered | guanfacine extended-release tablet |
| iodoquinol-hydrocortisone-aloe gel | No longer covered | Consult doctor |
| Kapspargo sprinkle extended-release capsule | No longer covered | metoprolol succinate extended-release tablet |
| Katerzia suspension | No longer covered | Consult doctor |
| Keppra solution | No longer covered | levetiracetam solution |
| Keppra tablet | No longer covered | levetiracetam tablet |
| Keppra XR extended-release tablet | No longer covered | levetiracetam extended-release tablet |
| ketoconazole foam | No longer covered | ketoconazole cream |
| Lamictal tablet | No longer covered | lamotrigine tablet |
| Lamictal chewable tablet | No longer covered | lamotrigine chewable tablet |
| Lamictal disintegrating tablet | No longer covered | lamotrigine disintegrating tablet |
| Lamictal XR extended-release tablet | No longer covered | lamotrigine extended-release tablet |
| Lidocaine-tetracaine cream | No longer covered | lidocaine-prilocaine cream |
| Locoid lipocream cream | No longer covered | hydrocortisone butyrate cream |
| Loprox shampoo | No longer covered | ciclopirox shampoo |
| Lucemyra tablet | No longer covered | Consult doctor |
| Luliconazole cream | No longer covered | ketoconazole cream |
| Lunesta tablet | No longer covered | eszopiclone tablet |
| Luxiq foam | No longer covered | betamethasone valerate foam |
| Luzu cream | No longer covered | ketoconazole cream |
| Lyrica capsule | No longer covered | pregabalin capsule |
| Lyrica solution | No longer covered | pregabalin solution |
| Lyrica CR extended-release tablet | No longer covered | pregabalin capsule |
| metoprolol succinate-hctz extended-release tablet | No longer covered | Consult doctor |
| Metrogel gel with pump | No longer covered | metronidazole gel |
| metronidazole gel with pump | No longer covered | metronidazole gel |
| Miconazole-zinc oxide ointment | No longer covered | ketoconazole cream |
| Mondoxyne NL capsule | No longer covered | doxycycline capsule |
| Mulpleta tablet | No longer covered | Consult doctor |
| Naftin gel | No longer covered | naftifine cream |
| Nalfon tablet | No longer covered | fenoprofen tablet |
| Neurontin capsule | No longer covered | gabapentin capsule |
| Neurontin solution | No longer covered | gabapentin solution |
| Neurontin tablet | No longer covered | gabapentin tablet |
| Okebo capsule | No longer covered | doxycycline capsule |
| Olux foam | No longer covered | clobetasol propionate foam |
| Olux-E foam | No longer covered | clobetasol propionate foam |
| oxiconazole nitrate cream | No longer covered | ketoconazole cream |
| Oxistat lotion | No longer covered | ketoconazole cream |
| Pataday drops | No longer covered | olopatadine drops |
| Pifeltro tablet | No longer covered | Consult doctor |
| Pravachol tablet | No longer covered | pravastatin tablet |
| Pristiq extended-release tablet | No longer covered | desvenlafaxine extended-release tablet |
| Prizotral cream | No longer covered | lidocaine-prilocaine cream |
| Provigil tablet | No longer covered | modafinil tablet |
| rabeprazole capsule | No longer covered | omeprazole capsule |
| Rhofade cream | No longer covered | Consult doctor |
| Sandostatin LAR depot vial | No longer covered | Consult doctor |
| Scalacort lotion | No longer covered | triamcinolone lotion |
| Sernivo aerosol spray | No longer covered | clobetasol spray |
| Seroquel tablet | No longer covered | quetiapine tablet |
| Seroquel XR extended-release tablet | No longer covered | quetiapine extended-release tablet |
| Signifor LAR vial | No longer covered | Consult doctor |
| Siklos tablet | No longer covered | hydroxyurea capsule |
| Soloxide tablet | No longer covered | Consult doctor |
| Strattera capsule | No longer covered | atomoxetine capsule |
| Striverdi Respimat inhaler | No longer covered | Consult doctor |
| Synera adhesive patch | No longer covered | lidocaine-prilocaine cream |
| Tikosyn capsule | No longer covered | dofetilide capsule |
| Topamax capsule | No longer covered | topiramate capsule |
| Topamax tablet | No longer covered | topiramate tablet |
| tretinoin microsphere gel with pump | No longer covered | tretinoin gel |
| triamcinolone acetonide aerosol | No longer covered | triamcinolone cream |
| Triderm cream | No longer covered | triamcinolone cream |
| Trileptal suspension | No longer covered | oxcarbazepine suspension |
| Trileptal tablet | No longer covered | oxcarbazepine tablet |
| Valium tablet | No longer covered | diazepam tablet |
| Victoza pen injector | No longer covered | Consult doctor |
| Vivlodex capsule | No longer covered | meloxicam tablet |
| Vizimpro tablet | No longer covered | Consult doctor |
| Vusion ointment | No longer covered | ketoconazole cream |
| Wellbutrin SR sustained-release tablet | No longer covered | bupropion sustained-release tablet |
| Xanax tablet | No longer covered | alprazolam tablet |
| Xanax XR extended-release tablet | No longer covered | alprazolam extended-release tablet |
| Xatmep solution | No longer covered | Consult doctor |
| Xelpros eye drops | No longer covered | latanoprost eye drops |
| Zavesca capsule | No longer covered | miglustat capsule |
| Zilacaine patch | No longer covered | lidocaine patch |
| Zithranol shampoo | No longer covered | Consult doctor |
| Zithranol rapid-release cream | No longer covered | Consult doctor |
| Zorvolex capsule | No longer covered | diclofenac tablet |
| Zytiga tablet | No longer covered | abiraterone acetate tablet |