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Important information about your prescription benefits Effective July 1, 2013
Within the Prescription Drug List (PDL), medications
are grouped by tier. The tier indicates the amount you pay when
you fill a prescription. Your lower-cost options are found in Tier 1.
Medications moving to a lower tier Medications may move from a higher tier to a lower tier, which can occur at any time throughout the year to provide members with immediate cost savings.
Condition Medication Name Utilization Effective Date Placement Allergies New benefit coverage The following medications, previously not covered under most of our benefit plans, will now be eligible for coverage under many plans. Tier placement for these medications is shown below. Condition Medication Name Utilization Effective Date Placement Cancer Pain Nasal Allergies
1. Pre-certification is already required to verify diagnosis. Medications moving to a higher tier We evaluate medications based on their total value, including how a medication works. When two or more medications work the same way, other factors, including cost, may play a role in their tier placement on the PDL. Medications may move to a higher tier because they offer less health care value than similar medications in their therapeutic classes. If your medication is listed below, you may continue taking it, but you may pay a higher cost. We encourage you to talk with your doctor about the lower-cost option(s) listed below that also may treat your condition. Condition Medication Name Utilization Lower-Cost Options Placement Excess Growth Sleepiness
(generic Ritalin LA), Adderall XR, Vyvanse
HIV-related Complication Low Platelet Migraine
sumatriptan succinate (generic Imitrex) fluticasone (generic Flonase),
Nasal Allergies Overactive Medications moving to a higher tier (continued) Condition Medication Name Utilization Lower-Cost Options Placement Pulmonary Arterial Hypertension Transplant Medications being added to the Select Designated Pharmacy Program2 Through this program, members must either fill their prescription by mail or switch to a lower-cost option, or do both in order to continue to receive network benefits. Call the number on the back of your health plan ID card to determine if this program applies to your benefit plan and for additional details about the program. Medication Condition Tier Placement Utilization Lower-Cost Options
fluoxetine (generic Prozac), paroxetine (generic Paxil),
Depression
sertraline (generic Zoloft), citalopram (generic Celexa), escitalopram (generic Lexapro)
Overactive
oxybutynin (generic Ditropan), oxybutynin extended-
release (generic Ditropan XL), trospium (Sanctura)
2. New York Small and Large Group Fully Insured groups only
Medications no longer covered under most of our benefit plans When several medications work in the same way, we may choose to not cover the higher-cost option. The medications listed below will no longer be covered under many of our pharmacy benefit plans. Medication New Benefit Condition Utilization Lower-Cost Options Coverage
Over-the-counter (OTC) salicylic acid products
3. Prescription drug products that are comprised of components that are available in over-the-counter form or equivalent are not covered under the pharmacy benefit plans
Medications that require pre-certification (Connecticut and New York only) The medications listed below require your physician to provide additional prescribing information to determine if coverage is available. New Benefit Condition Medication Name Utilization Lower-Cost Options Coverage Allergies/Asthma Breast Cancer
2013 Oxford Health Plans LLC. All rights reserved.
Please note not all PDL updates apply to all groups depending on state regulations,
UnitedHealthcare® and the dimensional U logo are registered marks owned by
Riders and Summary Plan Descriptions (SPDs). Oxford HMO products are
Unitedhealth Group, Inc. Applies to Advantage PDL. All branded medications are
underwritten by Oxford Health Plans (NY), Inc., Oxford Health Plans (NJ), Inc.and
trademarks or registered trademarks of their respective owners.
Oxford Health Plans (CT), Inc. Oxford insurance products are underwritten by
Medications that require pre-certification (Connecticut and New York only) - continued New Benefit Condition Medication Name Utilization Lower-Cost Options Coverage Cancer Pain Depression
Wellbutrin SR) bupropion extended-release (generic
Dermatitis Glaucoma High Blood Pressure
Diovan HCT) doxycycline hyclate (generic Vibramycin),
Monodox (brand only) Pre-certification4 0.28
Infections Inflammatory Bowel Disease
(generic Elimite), spinosad (generic Natroba)
Nasal Allergies
fluticasone (generic Flonase), azelastine
Osteoporosis
extended-release (generic Ambien CR) zaleplon (generic Sonata), zolpidem
Stroke and Heart Attack Prevention
Ketodan Combination Package Pre-certification5
Topical Fungal Infections
Ciclodan Combination Package Pre-certification5
2013 Oxford Health Plans LLC. All rights reserved.
Please note not all PDL updates apply to all groups depending on state regulations,
UnitedHealthcare® and the dimensional U logo are registered marks owned by
Riders and Summary Plan Descriptions (SPDs). Oxford HMO products are
Unitedhealth Group, Inc. Applies to Advantage PDL. All branded medications are
underwritten by Oxford Health Plans (NY), Inc., Oxford Health Plans (NJ), Inc.and
trademarks or registered trademarks of their respective owners.
Oxford Health Plans (CT), Inc. Oxford insurance products are underwritten by
Medications that require pre-certification (Connecticut and New York only) - continued New Benefit Condition Medication Name Utilization Lower-Cost Options Coverage
(Biaxin) + amoxicillin (Amoxil), PrevPac
Ulcers, Heartburn &
Protonix (brand only) Pre-certification4
4. For impacted plans, these medications may also move to the highest tier based on the benefit plan (Tier 4). Please refer to rider language to determine exclusion status. For Connecticut and New York, medications may be excluded unless medically necessary. 5. These medications were excluded at launch in Connecticut and New York (unless medically necessary) – pre-certification may already be in place. They are covered in New Jersey. For more information For questions about your pharmacy benefit, please visit oxfordhealth.com or call the Pharmacy
Customer Service member telephone number on the back of your health plan ID card. If you are hearing impaired and require assistance, please call our TTY/TDD line at 1-800-201-4875. Please call 1-800-303-6719 for assistance in Chinese, 1-888-201-4746 for assistance in Korean, or the telephone number on your health plan ID card for assistance in English and other languages.
2013 Oxford Health Plans LLC. All rights reserved.
Please note not all PDL updates apply to all groups depending on state regulations,
UnitedHealthcare® and the dimensional U logo are registered marks owned by
Riders and Summary Plan Descriptions (SPDs). Oxford HMO products are
Unitedhealth Group, Inc. Applies to Advantage PDL. All branded medications are
underwritten by Oxford Health Plans (NY), Inc., Oxford Health Plans (NJ), Inc.and
trademarks or registered trademarks of their respective owners.
Oxford Health Plans (CT), Inc. Oxford insurance products are underwritten by
EXXONMOBIL: REPORT TO SHAREOWNERS ON FINANCIAL RISKS RESULTING FROM CLIMATE CHANGE AND ITS IMPACT ON SHAREOWNER VALUE Whereas: There is general consensus among climate scientists that, without significant intervention, climate change will result in dramatic weather events, rising sea levels, drought in some areas, and significant impacts on human and ecosystem health. The Pentagon
CARDIOLOGY CONSULTANTS MEDICAL GROUP The Treadmill Cardiolite Stress Test is a non-invasive test used to evaluate your heart muscle and blood flow from the coronary arteries. Abnormalities in cardiac rhythm (EKG) and cardiac perfusion can be detected. The test is done in three parts, and takes 3-4 hours. Appointment Date :______________________ Arrival Time :________________ Appointm