Log in
Member
I have a Premera Health Plan
Medicare Advantage Member
I have a Medicare Advantage Plan
Medicare Supplement Member
I have a Medicare Supplement Plan
Employer
—Washington
Employer
—Alaska
Producer
I represent Premera plans
Provider
I'm a healthcare professional
Create Member Account
Pay My Bill
For members only
Toggle navigation
Providers
For Providers
Provider Home
Log In / Register
My Premera
Federal Employee Program
Join Our Network
Medicare Advantage 2017
Medical
Dental
Medicare Advantage
Medical
Dental
Tools
Eligibility & Benefits
Prior Authorization
Check Prior Authorization Status
Claims & Payments
Claims Editor
Electronic Funds Transfer
PCP Roster
Find a Doctor
Rx Search
Utilization Review
About Prior Authorization
AIM Specialty Health
Admission Notification
Outpatient Rehabilitation
Library
Forms
Reference Info
News
Health Management
Electronic Transactions
HIPAA
News
Pharmacy
About Pharmacy
Pharmacy Benefit Guide
Drugs Requiring Approval
Rx Search
Preventive Drug Lists
Drug List Changes
Mail Order Prescriptions
Specialty Pharmacy
Current location:
WA
Alaska
Providers
For Providers
Provider Home
Log In / Register
My Premera
Federal Employee Program
Join Our Network
Medicare Advantage
Medical
Dental
Tools
Eligibility & Benefits
Prior Authorization
Check Prior Authorization Status
Claims & Payments
Claims Editor
Electronic Funds Transfer
PCP Roster
Find a Doctor
Rx Search
Utilization Review
About Prior Authorization
AIM Specialty Health
Admission Notification
Outpatient Rehabilitation
Library
Forms
Reference Info
News
Health Management
Electronic Transactions
HIPAA
Pharmacy
About Pharmacy
Pharmacy Benefit Guide
Drugs Requiring Approval
Rx Search
Preventive Drug Lists
Drug List Changes
Mail Order Prescriptions
Specialty Pharmacy
Drug List Changes
Effective April 01, 2019
Formulary Changes to the Preferred B2 Drug List
Drug Name
Description of Change
Cost-effective Alternatives*
Albenza tablet
No longer covered
albendazole tablet
Amicar tablet
No longer covered
aminocaproic acid tablet
Androgel gel packet
No longer covered
testosterone gel packet
Canasa suppository
No longer covered
mesalamine suppository
Elidel topical cream
No longer covered
pimecrolimus topical cream
Finacea topical gel
No longer covered
azelaic acid topical gel
Zytiga tablet
No longer covered
abiraterone acetate tablet
Formulary Changes to the Preferred B3 and B4 Drug Lists
Drug Name
Description of Change
Cost-effective Alternatives*
Albenza tablet
Moving to a higher level
albendazole tablet
Amicar tablet
Moving to a higher level
aminocaproic acid tablet
Androgel gel packet
Moving to a higher level
testosterone gel packet
Canasa suppository
Moving to a higher level
mesalamine suppository
Elidel topical cream
Moving to a higher level
pimecrolimus topical cream
Finacea topical gel
Moving to a higher level
azelaic acid topical gel
Zytiga tablet
Moving to a higher level
abiraterone acetate tablet
Formulary Changes to the E4 Drug List
Drug Name
Description of Change
Cost-effective Alternatives*
Androgel gel packet
Moving to a higher level
testosterone gel packet
Zytiga tablet
Moving to a higher level
abiraterone acetate tablet
Formulary Changes to the M1, M2 and M4 (2019) Drug Lists
Drug Name
Description of Change
Cost-effective Alternatives*
Albenza tablet
No longer covered
albendazole tablet
Amicar tablet
No longer covered
aminocaproic acid tablet
Ampyra extended-release tablet
No longer covered
dalfampridine extended-release tablet
Androgel gel packet
No longer covered
testosterone gel packet
Butrans patch
No longer covered
buprenorphine patch
Canasa suppository
No longer covered
mesalamine suppository
Elidel topical cream
No longer covered
pimecrolimus topical cream
Evekeo tablet
No longer covered
amphetamine tablet
Finacea topical gel
No longer covered
azelaic acid topical gel
Fortesta topical gel
No longer covered
testosterone topical gel
Onfi suspension
No longer covered
clobazam suspension
Onfi tablet
No longer covered
clobazam tablet
Rapaflo capsule
No longer covered
silodosin capsule
Zytiga tablet
No longer covered
abiraterone acetate tablet
Formulary Changes to the M1, M2 and M4 (2018) Drug Lists
Drug Name
Description of Change
Cost-effective Alternatives*
Albenza tablet
No longer covered
albendazole tablet
Amicar tablet
No longer covered
aminocaproic acid tablet
Ampyra extended-release tablet
No longer covered
dalfampridine extended-release tablet
Androgel gel packet
No longer covered
testosterone gel packet
Butrans patch
No longer covered
buprenorphine patch
Canasa suppository
No longer covered
mesalamine suppository
Elidel topical cream
No longer covered
pimecrolimus topical cream
Evekeo tablet
No longer covered
amphetamine tablet
Finacea topical gel
No longer covered
azelaic acid topical gel
Fortesta topical gel
No longer covered
testosterone topical gel
Onfi suspension
No longer covered
clobazam suspension
Onfi tablet
No longer covered
clobazam tablet
Rapaflo capsule
No longer covered
silodosin capsule
Zytiga tablet
No longer covered
abiraterone acetate tablet
Formulary Changes to the Select C4 Drug List
Drug Name
Description of Change
Cost-effective Alternatives*
Amicar tablet
Moving to a higher level
aminocaproic acid tablet
Zytiga tablet
Moving to a higher level
abiraterone acetate tablet
*These drugs have been selected by an independent group of experts made up of doctors and pharmacists. This group reviews drugs to see how well they work relative to their cost. They also compare their effectiveness to similar drugs used to treat the same condition. Please talk with your doctor to see if these new options are right for you.
facebook
twitter
youtube
premera blog