Pharmacy Benefits and Formulary
2013 Formulary Changes
2013 SD/ND/IA Pharmacy Benefits/Formulary
2013 MN Pharmacy Benefits/Formulary
Covered Generic Oral Contraceptives
Pharmacy coverage changes
Maintenance Drug List (drugs available as a 90 day supply for three (3) copays)
The following drugs have been added to the Maintenance Drug List:
Alendronate
Bupropion
Citalopram
Escitalopram
Fluoxetine
Fluvoxamine
Mirtazapine
Omeprazole
Pantoprazole
paroxetine
Risperidone
Sertraline
Tamoxifen
Trazadone
Venlafaxine
Medications for Migraine Headache
Quantity Limits for migraine medications have been increased. These limits are for one prescription at one copay:
| naratriptan |
LIMIT 9/rx |
| sumatriptan tablets |
LIMIT 12/rx |
| sumatriptan injections |
LIMIT 1 kit/rx |
| sumatriptan nasal spray |
LIMIT 6/rx |
| AXERT |
LIMIT 6/rx |
| FROVA |
LIMIT 9/rx |
| MAXALT, -MLT |
LIMIT 12/rx |
| MIGRANAL |
LIMIT 4/rx |
| RELPAX |
LIMIT 12/rx |
| ZOMIG, -ZMT |
LIMIT 12/rx |
| ZOMIG NASAL SPRAY/AMPULE |
LIMIT 6/rx |
| 
