Agent Guide | Short Term Care
ManhattanLife
Medications/Therapeutic Use Reference These medications are a list of prescription drugs and their common therapeutic use. These prescription drugs are not limited to the treatment of the conditions indicated. This list is by no means complete since it would be impossible to list every medication in an easy reference guide. Mirapex/Pramipexole & Requip/Ropinirole-complete Phone Health Interview & verify diagnosis, if used to treat restless leg syndrome and dose/frequency < 4mg QD, may be considerable. Truvada/Emtricitabine Tenofovir-complete Phone Health Interview & verify diagnosis & how prescribed, if used as a preventative measure only, may be considered. • Medications in red will result in a decline. • Medications in teal will require a Phone Health Interview to determine diagnosis.
LIMITED BENEFITS
MEDICATION
CONDITION
DECLINE
Abilify
Schizophrenia/Bipolar Disorder
Y
Abiraterone Acetate
Cancer
Y
Aggrenox Albuterol
Prevent Blood Clot/Stroke
Y Y
Asthma/COPD
Alkeran
Cancer
Y
High Blood Pressure/ Congestive Heart Failure
Altace
Y
Anastrozole
Breast CA
Y
Antabuse
Alcoholism
Y
Anemia in pts w/Chronic Renal Failure & CA Chemotherapy
Aranesp
Aricept
Alzheimer's Disease/Memory Loss
Y Y
Arimidex
Breast CA
Aripiprazole
Schizophrenia/Bipolar
Y
Atacand Atrovent Avastin Avonex
Heart Failure/High Blood Pressure
COPD/Asthma
Y
Cancer
Y
MS
Y
Azathioprine
Prevent Kidney Transplant Rejection/RA
AZT
HIV/AIDS
Y
Benazepril Benztropine Bevacizumab
CHF/Renal Failure/High Blood Pressure
Parkinson's Disease
Cancer
Y
13
AGT-STC 0125
Made with FlippingBook. PDF to flipbook with ease