JH Underwriting Guide

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Prescription drug exclusions There is a likelihood that proposed insureds will be declined if they are currently taking or have taken any of the following medications. This is not an all-inclusive drug list. Additional medications or combinations of medications may be added to this list at John Hancock’s discretion.

Eligibility

Risk class criteria

Medication (Generic name) Abacavir Abilify (Aripiprazole) Aggrenox Alkeran (Melphalan) Ampyra (Dalfampridine) Anoro Ellipta Antabuse (Disulfiram) Aranesp (Darbepoetin alfa) Aricept (Donepezil) Arimidex (Anastrozole) Artane (Trihexyphenidyl) Atripla Avinza (Morphine sulfate) Avonex (Interferon Beta - 1a) Azilect (Rasagiline) Betaseron (Interferon beta - 1b)

Medication (Generic name) Coumadin (Warfarin) Crixivan ( Indinavir) Cyloserine (Seromycin) Cytoxan (Cyclophosphamide) Digoxin (Lanoxin) Duragesic Patch (Fentanyl transdermal system) Eliquis (Apixaban)

Medication (Generic name) Invirase (Saquinavir) Lanoxin (Digoxin) Latuda (Lurasidone) Lexiva (Fosamprenavir) L-Dopa/Levodopa Lithium (Eskalith, Lithobid, Carbolith, Lithane, Lithmax) Lovenox (Enoxaparin)

Medication (Generic name) Ranexa (Ranolazine)

Razadyne (Galantamine) Rebif (Interferon beta - 1a) Reminyl (Galantamine) Ridura (Auranofin) Retrovir (Zidovudine) Revia (Naltrexone) Ribavirin (Tribavirin) Risperdal (Risperidone)

Prescription drug exclusions

Epivir Hbv (Lamivudine) Epogen (Epoetin alfa) Ergoloid (Hydergine) Exelon (Rivastigmine) Femara (Letrozole) Fentanyl Patch Galantamine (Razadyne) Geodon (Ziprasidone) Gleevec (Imatinib) Gengraf (Cyclosporine)

Leukeran (Chlorambucil) Meallaril (Thioridazine) Mestinon (Pyridostigmine) Methadone (Dolophine) Methotrexate (Amethopterin) Mirapex (Pramipexole) Mitomycin Morphine Sulfate (MS Contin) MS Contin (Morphine Sulfate)

Build charts & Database checks

Saphris (Asenapine) Seroquel (Quetiapine) Sinemet (Carbidopa-Levodopa) Stalevo (Carbidopa, Levodopa & Entacapone) Stribild (Elvitegravir, Cobicistat, Emtricitabine, Tenofovir) Suboxone (Buprenorphine/Naloxone, Subutex) Sustiva (Efavirenz)

FAQs

Namenda (Memantine) Navane (Thiothixene) Neulasta (Pegfilgrastim)

Symbyax (Olanzapine/Fluoxetine) Tamoxifen (Nolvadex, Soltamox) Tysabri (Natalizumab) Viracept (Nelfinavir) Warfarin (Coumadin, Jantovin) Xarelto (Rivaroxaban) Xeljanz (Tofacitinib) Xyrem (Sodium oxybate)

Campath (Alemtuzumab) Campral (Acamprosate) Carbidopa/Levodopa

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Haldol (Haloperidol) Haloperidol (Haldol) Hepsera (Adefovir dipivoxil) Humira (Adalimumab) Hydrea (Hydroxycarbamide, Hydroxyurea) Imuran (Azathioprine) Infergen (Interferon alfacon - 1) Interferon Invega (Paliperidone)

Pegasys (Peginterferon alfa - 2a) Peg-Intron (Peginterferon alfa - 2b)

Carvedilol (Coreg) Clopidogrel (Plavix) Clozapine (Clozaril) Cogentin (Benztropine mesylate) Cognex (Tacrine) Combivir (Lamivudine/Zidovudine) Coreg (Carvedilol)

Perphenazine (Trilafon) Pradaxa (Dabigatran)

Procrit (Epoetin alfa) Prograf (Tacrolimus) Purinethol (Mercaptopurine)

Zenapax (Daclizumab) Zyprexa (Olanzapine)

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