› When using the lookup tool for your plan’s formulary, search by the generic name shown here. › Only the generic versions of the product names are covered. › Keep in mind that multiple store brands are available as generic drugs. Covered Over-the-Counter Generic Medications
Type of Therapy
Medication Brand Name
Generic Name
Benadryl tabs, liquid
Diphenhydramine
Cough, cold, allergy
Claritin tabs, syrup
Loratadine
Dextromethorphan liquid, syrup
Guaifenesin
Nasalcrom nasal spray
Cromolyn
Ocean 0.65% nasal spray
Saline
Robitussin syrup, liquid
Phenylephrine tablet
Sudafed tabs, liquid
Pseudoephedrine
Zyrtec tabs, solution
Cetirizine
Clotrimazole cream, vaginal cream Clotrimazole Hydrocortisone cream, gel, lotion, ointment, solution (various name brands) Hydrocortisone Miconazole cream, vaginal cream and suppository Miconazole Tolnaftate cream, solution, aerosol Tolnaftate
Dermatology
Artificial tears (various name brands)
Artificial tears
Eyes (ophthalmic)
Zaditor OTC 0.025%
Ketotifen
Citrate of Magnesium solution
Magnesium citrate
Gastrointestinal
Dulcolax tabs, suppositories
Bisacodyl
Fleet Enema
Sodium phosphate
Metamucil powder
Psyllium
Miralax powder
Polyethylene glycol 3350
Pepcid tabs
Famotidine
Senna 8.6mg tabs
Senna, sennosides
Tagamet tabs
Cimetidine
Ibuprofen 100mg/5mL suspension
Ibuprofen
Pain
Harvard Pilgrim Health Care includes Harvard Pilgrim Health Care, Harvard Pilgrim Health Care of New England and HPHC Insurance Company.
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