Central California Alliance for Health | Living Healthy | December 2018

7 HEALTHY DRUG NAME USED FOR ACTION Xopenex HFA Asthma and COPD Added Spiriva HandiHaler, Spiriva Respimat, Utibron Neohaler, Anoro Ellipta, Breo Ellipta, Dulera, Symbicort, Advair Diskus, Tudorza, Advair HFA, Alvesco, Stiolto Respimat Asthma and COPD Removed Diastat (diazepam rectal gel) Seizures Added, with limit of 2 kits per 365 days Diphenhydramine chew tablets Allergy Added Flonase Sensimist Allergy Added for children 2 to 4 years old Cetirizine capsule, Levocetirizine, Loratadine capsule, Mometasone furoate (Nasonex) Allergy Removed Benzonatate 150mg capsule Cough Removed Brompheniramine/pseudoephedrine/dextromethorphan 1-2.5-5/5 solution Cold Added Prenatal vitamin Pregnancy Added; changed PA criteria for non-formulary Formulary changes your Medicare benefits and how to use them. You can reach HICAP at: X  X Merced County: 209-385-7550 X  X Monterey County: 831-655-1334 X  X Santa Cruz County: 831-462-5510 Other important phone numbers to know: The services below are covered by the Alliance: X  X Routine vision services (eye exams, glasses): VSP, 1-800-877-7195 Please note: Glasses are covered only for members under 21, those in skilled or intermediate nursing facilities, and those who are pregnant. X  X Mental health services: Beacon Health Options, 1-855-765-9700 This service is covered by Medi-Cal, not the Alliance: X  X Dental Services: Denti-Cal, 1-800-322-6384