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member news
Do you have questions about your health? The Alliance can help!
Call the FREE Alliance Nurse Advice Line for answers
24 hours a day, 7 days a week at
1-844-971-8907
.
Do you need help managing your health? Call the Case
Management Line at
1-800-700-3874,
ext. 5512
. Or if you
would like health education information, please call
the Health Education Line at
1-800-700-3874, ext. 5580
.
You can talk to someone in our Care Management team
from 8 a.m. to 5 p.m. Monday through Friday.
Formulary changes
Drug name
Used for
Action
»
True Metrix
Diabetes
glucose meter
Added
»
Butalb/APAP/caffeine 50-300-40 capsule
Migraine
Added (Quantity limit of
180 per 30 days)
»
Hydrocodone/ibuprofen 7.5mg-200mg tablet
»
APAP w/ codeine 300mg-60mg
Pain
Added (Quantity limit of
180 per 30 days)
»
Pseudoephedrine/cetirizine 5mg-120mg tab ER 12H
»
Pseudoephedrine/Fexofenadine 60mg-120mg tab ER 12H
»
Pseudoephedrine/Fexofenadine 180mg-240mg tab ER 24H
»
Pseudoephedrine/Loratadine 10mg-240mg tab ER 24H
Allergy and
congestion
Added
»
Fexofenadine 30mg/5ml oral susp
»
Loratadine 5mg rapid dissolve tablet
Allergy
Added
»
Azelastine 205.5mcg nasal spray
Allergic
rhinitis
Added
»
HepaGam B vial
»
HyperHEP B S-D syringe
and vial
»
Nabi-HB vial
»
Imogam Rabies-HT
»
HyperTET S-D syringe
»
HyperRAB S-D vial
»
Prevnar 13 syringe
»
Pneumovax 23 vial
»
Adacel Tdap syringe
Vaccine
Added
»
Levocetirizine 5mg tablet
Allergy
Part of the step therapy.
Requires trial and failure
of cetirizine.
»
Hydrocodone/APAP tablet (all strengths)
»
Tramadol 50mg tablet
Pain
Quantity limit change:
180 tablets per 30 days
»
Hydrocodone/APAP solution (all strengths)
Pain
Quantity limit change:
2700 mls per 30 days
»
Oxycodone/APAP tablet (all strengths)
»
Oxycodone IR tablet (all strengths)
»
Methadone tablet (all strengths)
Pain
Quantity limit change:
120 tablets per 30 days
»
Morphine sulfate ER tablet (all strengths)
»
Hydromorphone tablet (all strengths)
Pain
Quantity limit change:
60 tablets per 30 days
»
Morphine sulfate ER solution (all strengths)
Pain
Quantity limit change:
300 mls per 30 days
»
Butalb/APAP/caffeine 50-325-40 capsule
Migraine
Quantity limit change:
180 capsules per 30 days
4
living
healthy