Preventive Drug Benefit for HSA Plans Effective January 1, 2025
Value formulary Your coverage includes a preventive drug benefit. This means that preventive drugs (medications to help prevent chronic conditions and illnesses) are covered outside of your plan’s deductible. Instead, you will pay the applicable copayment or coinsurance amount. Over-the-counter products are not included in this benefit. This is a list of the most commonly prescribed preventive drugs. Limitations and restrictions may apply. Brand-name drugs have a capital letter; all others are generic drugs.
Anticoagulants & platelet aggregation inhibitors for STROKE PREVENTION anagrelide aspirin-dipyridamole Brilinta cilostazol clopidogrel dipyridamole Eliquis enoxaparin fondaparinux
Antineoplastics for BREAST CANCER
glimepiride glipizide glipizide extended-release glipizide/metformin
Lyumjev metformin metformin ER miglitol nateglinide Ozempic pioglitazone
anastrozole exemestane letrozole Soltamox tamoxifen toremifene
glucagon glyburide glyburide/metformin Gvoke Humalog Humalog Mix
pioglitazone/glimepiride pioglitazone/metformin repaglinide Rybelsus Symlin SymlinPen Synjardy
Blood glucose regulators for DIABETES*
Humulin Janumet Janumet XR Januvia Jardiance Jentadueto Lantus Lantus Solostar
acarbose alogliptin Baqsimi Bydureon Byetta Cycloset diazoxide suspension Farxiga
Fragmin heparin Jantoven prasugrel warfarin Xarelto Zontivity
Synjardy XR tolbutamide Toujeo Solostar
* Note: Diabetic supplies (i.e., blood glucose meters, test strips, lancets, syringes) are covered under Preventive Drug Benefit with prescription. This Preventive Drug List is not all-inclusive and is subject to change to comply with IRS guidance and as formulary updates are made. For the current Harvard Pilgrim Health Care formulary please see harvardpilgrim.org/rx . Flyer Last Updated October 8, 2024; effective 1/1/25.
P1508983520-1024
12
Made with FlippingBook - Online magazine maker