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Your Anthem prescription drug plan is a plan you can count on. The three-tier design covers nearly any prescription medica- tion available on the market today. Typically, first Tier prescriptions are low-cost or generic drugs and Tiers 2 and 3 are brand-name drugs. You can expect to pay the most for medications on Tier 3.
Visit anthem.com for the most up-to-date information about your prescription medications. The site has tools you can use to check potential drug interactions and learn more about lower-cost alternatives, including generic and over-the-counter drugs. In some cases, lifestyle choices can impact the amount of health care needed, as well. Making a few changes, like stopping smoking, losing weight or exercising more regularly may help alleviate the symptoms of some conditions. Talk to your doctorabout the lifestyle changes or drug alternatives that may be right for you. For a more complete list of alternative choices for a particular medication, log on to anthem.com and click on the Drug Listing from the Virginia member home page. The following chart highlights the medications most commonly used by Anthem members and lists less expensive options for Some drugs on this list may not be covered by your plan. Please refer to your benefit booklet for specific coverage on these drugs. Tier 2 - Seroquel / Tier 1 - chlorpromazine Anti-Ulcer Preps/Gastrointestinal Preps 3 Tier 2 - Prevacid, Protonix / OTC - Prilosec Tier 1 - hydromorphone (Dilaudid), morphine Tier 1 - glipizide (Glucotrol), metformin Tier 1 - methylphenidate (Ritalin), amphetamine Tier 2 - Flonase, Nasonex / Tier 1 - flunisolide Tier 2 - Flonase, Nasonex / Tier 1 - flunisolide Tier 1 - lisinopril (Zestril), captopril (Capoten) Tier 1 - glipizide (Glucotrol), metformin Tier 1 - triazolam (Halcion), temazopam (Restoril) Tier 1- amoxicillin/clavulanate (Augmentin) Tier 1 - glipizide (Glucotrol), metformin Tier 1 - glipizide (Glucotrol), metformin Tier 1 - naproxen (Naprosyn)/ OTC - ibuprofen Tier 1 - cyclosporine (Imuran, Sandimmune) Tier 1 - ipratropium (Atrovent), albuterol Tier 1 - Methylphenidate (Ritalin), amphetamine Tier 2 - Lipitor, Zocor / Tier 1 - lovastatin Tier 2 - Effexor XR, Tier 1 - bupropion SR Tier 1 - lisinopirl (Prinivil), fosinopril (Monopril) Tier 1 - hydromorphone (Dilaudid), oxycodone Tier 1 - amitriptyline (Elavil), bupropion SR Tier 2 - Cuprimine / Tier 1 - sulfasalazine All strengths except 12.5mg available generically Glipizide ER Diabetic Therapy 2 Tier 1 - Glipizide ER (glucotrol XL)Humalog Tier 2 - Cuprimine / Tier 1 - sulfasalazine Tier 2 - Depakote / Tier 1 - carbamazepine Tier 2 - Grifulvin V / Tier 1- ketoconazole (Nizoral) Tier 1 - erythromycin (EES), ciprofloxacin (Cipro) Tier 1 - citalopram (Celexa), fluvoxamine (Luvox) Tier 1 - cholestyramine (Questran), lovastatin Tier 2 - Flonase, Nasonex / Tier 1 - flunisolide Anti-Ulcer Preps/Gastrointestinal Preps 3 Tier 1 - Omeprazole / Tier 2 - Prevacid, Protonix / OTC - Prilosec Tier 1 - cholestyramine (Questran), lovastatin Tier 1 - felodipine (Plendil), verapamil (Calan) Anti-Ulcer Preps/Gastrointestinal Preps 1 Tier 2 - Lipitor, Zocor / Tier 1 - lovastatin Tier 1 - estradiol (Estrace), estropipate (Ogen) Anti-Ulcer Preps/Gastrointestinal Preps 2 Tier 1 - cyclosporine (Imuran, Sandimmune) Anti-Ulcer Preps/Gastrointestinal Preps 2 OTC - Prilosec / Tier 2 - Prevacid / Tier 1 - Omeprazole Anti-Ulcer Preps/Gastrointestinal Preps 1 Tier 1 - chlorpromazine (Thorazine), haloperidol Tier 1 - chlorpromazine (Thorazine), haloperidol Tier 2 - Dantrium / Tier 1 - diazepam (Valium) Tier 1 - methylphenidate (Ritalin), amphetamine Tier 1 - gabapentin (Neurontin), carbamazepine Tier 1 - propranolol (Inderal), metoprolol (Lopressor) Tier 2 - Depakote / Tier 1 - carbamazepine (Tegretol) Tier 1 - lovastatin (Mevacor) / Tier 2 - Zocor; Lipitor Tier 1 - cholestyramine (Questran), lovastatin Tier 1 - fluoxetine (Prozac), paroxetine (Paxil) Tier 1 - chlorpromazine (Thorazine), haloperidol Tier 2 - Flonase, Nasonex / Tier 1 - Flunisolide As you know, health insurance premiums rise to accommodate the rising cost of health care; prescription drugs account for abouta fifth of that cost.1 The average annual prescription drug expense for an American household is $812.1 There are things you can do to prevent or reduce unnecessary Average 30-Day Cost for Common Drugs
increases in health care costs for your family. A good startingplace is to learn about the medications you are taking and find out if you might be able to save money by switching toan equally effective, less costly drug.
The highest cost drugs usually are found on tier three. Be sure
to ask your doctor about generic and lower-tier alternatives to brand-name medications. The best alternative may not be a pre-scription medication at all, but an over-the-counter version. You may be able to reduce your out-of-pocket prescription drug costs
by consulting with your doctor to find a lower-cost medication
Remember that using mail order may help you save moneyalso. When you purchase more than a month’s worth of medications and supplies by using the 90-day supply mail order option, you can save on maintenance medication costs.
1 Kashihara, D. and Carper, K. National Health Care Expenses in the U.S. Community Population, 2002 Statistical Brief #61. December 2004. Agency for Healthcare Research and Quality, Rockville, MD. http://www.meps.ahrq.gov/papers/st61/stat61.pdf Trust Your GenericsIf you've ever wondered if generics are just as good as brands, rest assured they are. The standards set by the Food and DrugAdministration require that generic drugs be chemically identical to their brand-name counterparts and equal in safety,strength and effectiveness.
Anthem Blue Cross and Blue Shield is the trade name of Anthem Health Plans of Virginia, Inc.
Anthem Blue Cross and Blue Shield and its affiliated HMOs, HealthKeepers, Inc., Peninsula Health Care, Inc. and Priority Health Care, Inc., are independent licensees of the Blue Cross and Blue Shield Association.
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