Formulary

Generic Branded Equivalent Category
ACYCLOVIR ZOVIRAX Anti-infectives
ALBUTEROL INHALATION AERSOL PROAIR HFA Respiratory
ALBUTEROL SULFATE VENTOLIN Respiratory
ALENDRONATE SODIUM FOSAMAX Musculoskeletal
ALLOPURINOL ZYLOPRIM Anti-Gout
AMIODARONE CORDARONE Anti-arrhythmic
AMYTRIPTYLINE ELAVIL Anti-depressant
AMLODIPINE NORVASC Cardiovascular
AMLODIPINE/BENAZEPRIL LOTREL Cardiovascular
APRI 28 DAY APRI OB/GYN
ARIPIPRAZOLE ABILIFY Central Nervous System
ARIPIPRAZOLE ABILIFY Anti-psychotic
ASPIRIN EC ECOTRIN Anti-inflammatory/ Analgesics
ATENOLOL TENORMIN Cadiovascular
ATENOLOL/CHLORTHALIDONE TENORETIC Cardiovascular
ATORVASTATIN CALCIUM LIPITOR Cadiovascular
AUGMENTED BETAMETHASONE DIPROLENE AF Topical Agents
BACLOFEN LIORESAL Musculoskelatal
BENAZEPRIL LOTENSIL Cardiovascular
BACLOFEN HCL LIORESAL Musculoskelatal
BENAZEPRIL HCL/HCTZ LOTENSIL HCT Cardiovascular
BUPROPION SR WELLBUTRIN SR Smoking Aid
BUPROPION XL WELLBUTRIN XL Central Nervous System
BUSPIRONE HCL BUSPAR Anti-anxiety
CALCIUM CARBONATE W/ VIT D3 CHEW CALCIUM CARBONATE Dietary Supplements
CALCIUM CARBONATE W/ VIT D3 TAB CALCIUM CARBONATE Dietary Supplements
CAPTOPRIL CAPOTEN Cardiovascular
CAPTOPRIL/HCTZ CAPOZIDE Cardiovascular
CARBIDOPA/LEVODOPA SINEMET Anti-parkinson
CARVEDILOL COREG Cardiovascular
CELECOXIB CELEBREX Anti-inflammatory/ Analgesics
CETIRIZINE ZYRTEC Respiratory
CILOSTAZOLE PLETAL Cardiovascular
CITALOPRAM CELEXA Central Nervous System
CLONIDINE CATAPRES Cardiovascular
CLOPIDOGREL PLAVIX Cardiovascular
CLOTRIMAZOLE LOTRIMIN Anti-fungal
CYANOCOBALAMIN CYANOCOBALAMIN Dietary Supplement
CYCLOBENZAPRINE FLEXERIL Musculoskeletal
DICLOFENAC SODIUM VOLTAREN Anti-inflammatory/ Analgesics
DICYCLOMINE BENTYL Anti-cholinergic
DIGOXIN LANOXIN Anti-arrhythmic
DILTIAZEM CD ER CARDIZEM CD Cardiovascular
DIMENHYDRINATE DRAMAMINE Nausea & Vomiting
DIPYRIDAMOLE PERSANTINE Cardiovascular
DIVALPROEX DR DEPAKOTE SR Anti-convulsant
DONEPEZIL ARICEPT Anti-dementia
DOXYCYCLINE MONODOX Anti-Infectives
DULOXETINE CYMBALTA Central Nervous System
ENALAPRIL MALEATE VASOTEC Cardiovascular
ENALAPRIL MALEATE/HCTZ VASERETIC Cardiovascular
ERGOCALCIFEROL VITAMIN D Dietary Supplements
ESCITALOPRAM OXALATE LEXAPRO Central Nervous System
ESOMEPRAZOLE NEXIUM Gastrointestinal
ESTRADIOL PATCH VIVELLE-DOT/ALORA/MINIVELLE Endocrine
ESTRADIOLE TAB ESTRACE Endocrine
ESTRADIOLE/NORETHINDRONE ACETATE ACTIVELLA Endocrine
EZETIMIBE ZETIA Cholesterol
EZETIMIBE ZETIA Anti-lipemic/ Cardiovascular
FAMOTIDINE PEPCID Gastrointestinal
FENOFIBRATE LOFIBRA Cardiovascular
FERROUS GLUCONATE FERROUS GLUCONATE Dietary Supplements
FERROUS SULFATE FERROUS SULFATE Dietary Supplements
FERROUS SULFATE FER-IN-SOL Dietary Supplements
FLECAINIDE FLECAINIDE ACETATE Cardiovascular
FLUOXETINE PROZAC Central Nervous System
FLUCTICASONE SPRAY FLONASE Respiratory
FOLIC ACID FOLIC ACID Dietary Supplements
FOSINOPRIL SODIUM MONOPRIL Cardiovascular
FOSINOPRIL SODIUM/HCTZ MONOPRIL HCT Cardiovascular
FUROSEMIDE LASIX Cardiovascular
GABAPENTIN NEURONTIN Central Nervous System
GLIMEPIRIDE AMARYL Endocrine
GLIPIZIDE GLUCOTROL Endocrine
GLIPIZIDE XL GLUCOTROL XL Endocrine
GLYBURIDE MICRONASE Endocrine
HYDROCHLOROTHIAZIDE HYDRODIURIL Cardiovascular
HYDROCORTISONE HYTONE Topical agents
HYDROXYCHLOROQUINE HYDROXYCHLOROQUINE SULFATE Anti-infectives
IBUPROFEN MOTRIN Anti-inflammatory/ Analgesics
IPRATROPIUM/ALBUTEROL DUONEB Respiratory
IRBESARTAN AVAPRO Cardiovascular
JUNEL FE GILDESS FE OB/GYN
LAMOTRIGINE LAMICTAL Anti-convulsant
LANCET 28G LANCET 28G Diabetes
LEVETIRACETAM KEPPRA Anti-convulsant
LEVOCETIRIZINE XYZAL Anti-histamine
LEVOTHYROXINE SODIUM SYNTHROID Endocrine
LISINOPRIL ZESTRIL Cardiovascular
LISINOPRIL/HCTZ ZESTORETIC Cardiovascular
LORATADINE CLARITIN Respiratory
LOSARTAN POTASSIUM COZAAR Cardiovascular
LOSARTAN POTASSIUM HYDROCHLOROTHIAZIDE HYZAAR Cardiovascular
LOVASTATIN MEVACOR Cholesterol
LOVASTATIN MEVACOR Cardiovascular
MECLIZINE ANTIVERT Anti-histamine
MEDROXYPROGESTERONE ACETATE PROVERA Endocrine
MELOXICAM MOBIC Anti-inflammatory/ Analgesics
METFORMIN GLUCOPHAGE Endocrine
METFORMIN ER GLUCOPHAGE XR Endocrine
METOPROLOL SUCCINATE ER TOPROLXL Cardiovascular
METOPROLOLTARTRATE METOPROLOL TARTRATE Cardiovascular
MIRTAZAPINE REMERON Anti-depressant
MOEXIPRIL HCL UNIVASC Cardiovascular
MONTELUKAST SINGULAIR Respiratory
MONTELUKAST CHEW TAB SINGULAIR Respiratory
MULTI W/ FLUORIDE MULTI W/ FLUORIDE Dietary Supplement
MULTI W/ FLUORIDE & IRON MULTI W/ FLUORIDE & IRON Dietary Supplement
NAPROXEN NAPROSYN Anti-inflammatory/ Analgesics
NIKKI YAZ OB/GYN
OLMESARTAN MEDOXOMIL BENICAR Cardiovascular
OLMESARTAN/HCTZ BENICAR HCT Anti-hypertensize/Diuretic
OMEPRAZOLE DR PRILOSEC Gastrointestinal
ONDANSETRON HCL ZOFRAN Nausea & Vomiting
ONDANSETRON ODT ZOFRAN ODT Nausea & Vomiting
OSELTAMIVIR TAMIFLU Anti-Infectives
OXYBUTYNIN DITROPAN Anti-spasmodic/ Urinary
PANTOPRAZOLE SODIUM PROTONIX Gastrointestinal
PEG-3350 AND ELECTROLYTES GOLYTELY Gastrointestinal
PEG-3350 AND ELECTROLYTES TRILYTE Gastrointestinal
PEG-PREP + BISACODYL GAVILYTE-H/BISACODYL Gastrointestinal
PERINDOPRIL ACION Cardiovascular
PIOGLITAZONE HCI ACTOS Type 2 Diabetes
POTASSIUM CHLORIDE ER KLOR-CON Dietary Supplements
PRASUGREL EFFIENT Stroke
PRAVASTATIN PRAVACHOL Cardiovascular
PRENATAL MULTI PRENATAL MULTI Dietary Supplement
PRIMIDONE MYSOLINE Central Nervous System
PROCHLORPERAZINE COMPAZINE Nausea & Vomiting
PROMETHAZINE HCL PHENERGAN Nausea & Vomiting
PROPRANOLOL INDERAL Cardiovascular
QUETIAPINE SEROQUEL Anti-psychotic
QUINAPRIL HCL ACCUPRIL Cardiovascular
QUINAPRIL HCL/HCTZ ACCURETIC Cardiovascular
RALOXIFENE EVISTA Endocrine
RAMIPRIL ALTACE Cardiovascular
RAMIPRIL ALTACE Anti-hypertensize
RANITIDINE ZANTAC Gastrointestinal
RISPERIDONE RISPERDAL Anti-psychotic
ROPINIROLE REQUIP Anti-parkinson
ROSUVASTATIN CALCIUM CRESTOR Cardiovascular
SERTRALINE ZOLOFT Central Nervous System
SIMVASTATIN ZOCOR Cardiovascular
SPRINTEC PREVIFEM OB/GYN
SUMATRIPTAN TAB IMITREX Central Nervous System
TAMSULOSIN FLOMAX Miscellaneous agents
TIZANIDINE HYDROCHLORIDE ZANAFLEX Musculoskeletal
TOPIRAMATE TOPAMAX Anti-convulsant
TRANDOLAPRIL MAVIK Cardiovascular
TRAZODONE DESYREL Central Nervous System
TRI-SPRINTEC TRIPREVIFEM OB/GYN
TRIAMTERENE/HCTZ MAXZIDE Cardiovascular
TRUE METRIX METER TRUE METRIX METER Diabetes
TRUE METRIX TEST STRIPS TRUE METRIX TEST STRIPS Diabetes
VALSARTAN DIOVAN Cardiovascular
VALSARTAN/HYDROCHLOROTHIAZIDE DIOVAN Cardiovascular
VENLAFAXINE EFFEXOR Central Nervous System
VENLAFAXINE ER EFFEXOR XR Central Nervous System
VITAMIN D3/CHOLECALCIFEROL VITAMIN D Dietary Supplements
WARFARIN SODIUM COUMADIN Cardiovascular
WIXELA ADVAIR DISCUS Respiratory
XULANE XULANE OB/GYN

PHYSICIANS: Please e-prescribe to HomeMed Pharmacy, NCPDP#: 1533517

Please prescribe at least a 90-Day Supply when applicable.

Generic only, Brand Name are for reference only and are NOT covered.

Medications will be mailed within 48 hours of receipt of prescription - and delivered within 10 business days.

This program is free to employees who opt-in.

A list of medications covered by the supplemental plan will be provided for you to review with your physician.

A new prescription must be provided by your physician to HomeMed for each applicable medication.

HomeMed will not contact you for payment as the services is free of charge.

HomeMed pharmacists are available to provide medication counseling M-F, 9am-5pm ET.

Only medications specifically stated on the list are eligible for this program. No substitutions (e.g. manufacture, dosage, strength, form).

HomeMed reserves the right to add or remove medications from the covered list at its discretion.