drug list...drug list information we provide this list of the most commonly prescribed medications...

CGFLP04363 ©2018 Aetna Inc. 050418

For agent use only. Not for public use or distribution.

Drug ListAetna Senior Supplemental Insurance

Effective date: 05/04/2018

Drug list informationWe provide this list of the most commonly prescribed medications for declinable conditions to help you when you’re completing applications.New drugs for declinable conditions are regularly introduced. These drugs may be unacceptable even if they aren’t included in the list of unacceptable drugs.If you aren’t sure whether or not a medication is unacceptable, please contact the Underwriting Department.

• Your applicant may not be aware of a declinable condition listed on their application. Their prescribed medication may indicate a declinable condition exists.

• Some medications can be prescribed for multiple conditions. If your applicant is prescribed a medication that has multiple uses, you must provide the condition the medication is prescribed for.

The following drug list information is arranged alphabetically by medication.

lower case: generic nameUpper Case: brand nameX: Indicates that the medication is unacceptable for a product. If there are no conditions listed next to the medication, the medication is always unacceptable for a product. If there are conditions listed next to the medication, the medication is unacceptable for a product when prescribed for any of the listed conditions.NOTE: There are duplicate listings of several drugs. For some products, the medication is always unacceptable, and for others it’s unacceptable when prescribed for any of the listed conditions.NOTE: Final Expense has multiple plans available. If a medication is unacceptable for the level plan, make sure you check the other two plans. Your applicant may be eligible for the Graded or Modified benefit plan.You can always access the latest version of this guide on aetnaseniorproducts.com.

Content subject to change to ensure compliance with Aetna Senior Supplemental Insurance requirements.

2

You can use the letters below to quickly jump to the first page which contains medications starting with that letter of the alphabet.

A B C D E F G H I J K L M N O P Q R S T U V W X Y ZOr, if you’d like to search for a specific medication, just press Ctrl+F.

http://www.aetnaseniorproducts.com

3

Medicare Supplement

Final Expense - level

Final Expense - graded

Final Expense - modified

Cancer and Heart Attack or Stroke

Home Care Plus

Hospital Indemnity

Hospital Indemnity Flex

Recovery Care

Continental Care

Nursing Facility Care

Home Care

Drug name Condition

lower case: generic nameUpper Case: brand nameX: Indicates that the medication is unacceptable for a product. If there are no conditions listed next to the medication, the medication is always unacceptable for a product. If there are conditions listed next to the medication, the medication is unacceptable for a product when prescribed for any of the listed conditions.

Back to top

abacavir X

abatacept X

Abilify X X X X X

abiraterone X X

Abstral X

acamprosate X X X

AccessPak X X X X X X X X X X X

Aclasta X

Actemra rheumatoid arthritis X

Actigall X X X X

Actigall cirrhosis X X X

Actimmune X X X X X X X X

Actiq X

adalimumab X

Adcetris X X X X X X X X X

Adriamycin X X X X X X X X X X

Adrucil X X X X X X X X X X

Afrezza X

Afrezza (unit limits vary by product. see application)

X X X

Agrylin X X

Agrylin heart or artery disease X

Akineton Parkinson’s disease X X X X X X X

alefacept X

alemtuzumab X X X X X X X X X X

Alferon X X X X X X X X

4

Medicare Supplement





Home Care Plus

Hospital Indemnity


Recovery Care

Continental Care


Home Care

Drug name Condition


Back to top

Alkeran X X X X X X X X X

Alkeran multiple myeloma X X

amantadine Parkinson’s disease X X X X X X X

ambenonium X X X X X

Amevive X

amiodarone X

Amiodarone heart blockage X X

Ampyra X

anagrelide X X

anagrelide heart blockage X X

anakinra X

Anandron X X X X X X

anastrozole X X X X X X X X X X

Antabuse X X X X

apixaban

atrial fibrillation, arrhythmia, irregular heartbeat

X

apremilast X

arabinosylcytosine X

Aranesp X X

Arava X

Aredia X X X X X X X X X X

Aricept X X X X X X X X X

Arimidex X X X X X X X X X X

aripiprazole X X X X X X

Aromasin X X X X X X X X X

5

Medicare Supplement





Home Care Plus

Hospital Indemnity


Recovery Care

Continental Care


Home Care

Drug name Condition


Back to top

Artane Parkinson’s disease X X X X X X X

asenapine X

Astagraf XL X X X

Atamet Parkinson’s disease X X X X X X

atenolol + blood thinner


X

Atripla X X X X X X X X X X X

auranofin X

Aurolate X

Avastin X X X X X X X X X

Avinza X

Avonex X X X X X X

Avonex multiple sclerosis X

Axona X

Azapin

chronic ulcerative colitis or Chron’s disease

X

Azasan X X X

azathioprine X X X X

Azilect Parkinson’s disease X X X X X X X

AZT (azidothymidine) X X X X X X X X X X X X

baclofen multiple sclerosis X X X X X X X

6

Medicare Supplement





Home Care Plus

Hospital Indemnity


Recovery Care

Continental Care


Home Care

Drug name Condition


Back to top

BCG (Bacillus Calmette and Guérin)

X X X X X X X X X

benztropine Parkinson’s disease X X X X X X X

Betapace X

Betaseron X X X X X X

Betaseron multiple sclerosis X

bethanechol X

bevacizumab X X X X X X X X X

bexarotene X X X X X X X X X X

Bexxar X X X X X X X X X X X

bicalutamide X X X X X X X X X X

biperiden Parkinson’s disease X X X X X X X

Blenoxane X X X X X X X X X X

bleomycin X X X X X X X X X X

Bloxiverz X X X

brentuximab vedotin X X X X X X X X X

Brilinta X

Brilinta heart or artery disease X

bromocriptineParkinson’s disease, pituitary tumor

X X X X X X X

bumetanide

kidney failure, cirrhosis, congestive heart failure

X X X X X X X

7

Medicare Supplement





Home Care Plus

Hospital Indemnity


Recovery Care

Continental Care


Home Care

Drug name Condition


Back to top

Bumex


X X X X X X X

Bunavail X

buprenorphine X X X

busulfan X X X X X X X X X X

Busulfex X X X X X X X X X X

Calan + blood thinner


X

calcitriol

CKD, kidney failure, renal insufficiency, kidney disease/kidney disease requiring dialysis

X X X X X X X X X X

calcium acetate X X X X X X X X

Campath X X X X X X X X X X

Campral X X X X

Cannabis X

capecitabine X X X X X X X X X X

caprylic triglyceride X

caprylidene X

carbidopa Parkinson’s disease X X X X X X X

Cardioquin + blood thinner


X

Carimune X

8

Medicare Supplement





Home Care Plus

Hospital Indemnity


Recovery Care

Continental Care


Home Care

Drug name Condition


Back to top

carvedilol cardiomyopathy, heart disorder X X

carvedilol congestive heart failure X X X X X X

Casodex X X X X X X X X X X

CeeNu X X X X X X X X X X

CellCept X X X X

Cerespan Parkinson’s disease X X X X X X

certolizumab X

Cerubidine X X X X X X X X X X

cevimeline X

chlorambucil X X X X X X X X X X

chlorpromazine X X X X X X

cilostazol X X

Cilostazolcirculatory disease w/ diabetes

X X

Cimzia X

cinacalcet

CKD, kidney failure, renal insufficiency, dialysis may also treat cancer

X X X X X X X X X X

cisplatin X X X X X X X X X X

clopidogrel heart or artery disease X

clopidogrel peripheral vascular disease X X

clozapine X X X X X X

9

Medicare Supplement





Home Care Plus

Hospital Indemnity


Recovery Care

Continental Care


Home Care

Drug name Condition


Back to top

Clozaril X X X X X X

Cogentin Parkinson’s disease X X X X X X X

Cognex X X X X

Combivir X

Compazine X X

Comtan Parkinson’s disease X X X X X X X

Copegus X X X X

Cordarone X

Coreg cardiomyopathy, heart disorder X X

Coreg congestive heart failure X X X X X X

Cosmegen X X X X X X X X X X

Cotazym X X X

Coumadin


X

Covera + blood thinner


X

Creon X X

Crixivan X

cyclophosphamide X X X X X X X X X X

Cycloset X

cyclosporine X

10

Medicare Supplement





Home Care Plus

Hospital Indemnity


Recovery Care

Continental Care


Home Care

Drug name Condition


Back to top

cytarabine X X X X X X X X X X

Cytosar X X X X X X X X X X

Cytosar-U X

Cytoxan X X X X X X X X X X

dabigatran X

dactinomycin X X X X X X X X X X

dalfampridine X

Dantrium X X X X X X

Dantrium multiple sclerosis X

dantrolene X X X X X X

dantrolene multiple sclerosis X

darbepoetin alfa X X

daunorubicin X X X X X X X X X X

Dazidox X

Demadex X X X X X X X

Demadex kidney failure, cirrhosis X

Demerol X

Depade X X X

Descovy X

didanosine X X X X X X X X X X X

dideoxyinosine X X X X X X X X X X X

Didronel X X X X

Digitek


X

11

Medicare Supplement





Home Care Plus

Hospital Indemnity


Recovery Care

Continental Care


Home Care

Drug name Condition


Back to top

digoxin


X

Dilaudid X

Disipal X X X X

Diskets X X X

disulfiram X X

Docefrez X X X X X X X X X

docetaxel X X X X X X X X X X

dofetilide X

dofetilide heart or artery disease X

Dolophine X X X

Dom-Amiodarone heart or artery disease X

donepezil X X X

donepezil X X X X X X

Dopar Parkinson’s disease X X X X X X X

doxercalciferol

CKD, kidney failure requiring dialysis, kidney disease

X X X X X X X X X X

doxorubicin X X X X X X X X X X

dronabinol X X X

dronedarone X

dronedarone heart or artery disease X

Droxia X X X X X X X X X X X

12

Medicare Supplement





Home Care Plus

Hospital Indemnity


Recovery Care

Continental Care


Home Care

Drug name Condition


Back to top

Duragesic X

Dutoprol + blood thinner


X

Duvoid X

Dygase X X

edoxaban atrial fibrillation X

edoxaban heart or artery disease X

edrophonium X X X X

efavirenz X X X X X X X X X X X

Efudex X X X X X X X X X

Eldepryl Parkinson’s disease X X X X X X X

Eligard X X X X X X X X X X

Eliphos X X

Eliquis


X

Eliquiscirculatory disease w/ diabetes

X X

Eloxatin X X X X X X X X X X

Embeda X

Emcyt X X X X X X X X X X

emtricitabine X X X X X X X X X X X

Enbrel X

Encron-10 X X

13

Medicare Supplement





Home Care Plus

Hospital Indemnity


Recovery Care

Continental Care


Home Care

Drug name Condition


Back to top

Endocet X

Enlon X X X X X

entacapone Parkinson’s disease X X X X X X X

Entresto X X X X

enzalutamide X X

Epivir X X X X

eplerenone X

epoetin alfa X X X X X X X X X

Epogen X X X X X X X X X

Epzicom X

ergoloid mesylates X X X X X X X X X

erlotinib X X X X X X X X X

erythropoietin X X X X

Eskalith X X X X X X

estramustine X X X X X X X X X X

etanercept X

ETH-Oxydose X

etidronate X X

Etopophos X

etoposide X X X X X X X X X X

Etrafon Forte X X

Eulexin X X X X X X X X X

Evoxac X

Exelon X X X X X X X X X

14

Medicare Supplement





Home Care Plus

Hospital Indemnity


Recovery Care

Continental Care


Home Care

Drug name Condition


Back to top

exemestane X X X X X X X X X

Fareston X X X X X X X X X

Faslodex X X X X X X X X X X

Femara X X X X X X X X X X

fentanyl X X

Fentora X

filgrastim X X X X X X X X X X

Flebogamma X

flecainide X

flecainide heart or artery disease X

floxuridine X X X X X X X X X X

fluorouracil X X X X X X X X X X

fluoxetine major depressive disorder X

fluoxetinemajor depressive disorder, bipolar disorder

X

fluphenazine X X X X X X

flutamide X X X X X X X X X X

Folex PFS X

Foltx X

Forteo X

foscarnet X X

foscarnet sodium X X X X X

Foscavir X X X X X

Fosteum X

15

Medicare Supplement





Home Care Plus

Hospital Indemnity


Recovery Care

Continental Care


Home Care

Drug name Condition


Back to top

FUDR X X X X X X X X X X

fulvestrant X X X X X X X X X X

furosemide (40mg or more) X X X

furosemide (any amount)

congestive heart failure X X X

Gablofen multiple sclerosis X X X

galantamine X X X X X X X X X

GamaSTAN S/D X X X X

Gammagard X

Gammaplex X

Gammar X

Gamunex X

G-CSF (granulocyte-colony stimulating factor)

X X

gefitinib X X X X X X X X X X

gemtuzumab X X X X X X

Gen-Amiodarone heart or artery disease X

Gengraf X X X X

Geodon X X X X X X

Gleevec X X X X X X X X X X

gold sodium thiomalate X

golimumab X

goserelin X X X X X X X

Granix X

16

Medicare Supplement





Home Care Plus

Hospital Indemnity


Recovery Care

Continental Care


Home Care

Drug name Condition


Back to top

Guerin) X

Haldol X X X X X X

haloperidol X X X X X X

Harvoni X X

Harvoni hepatitis X X

Hecoria X X X

Hectorol kidney failure requiring dialysis X X X X X X X X X

Herceptin X X

histrelin X X X X

Hizentra X

Humira X X

Hydergine X X X X X X X X X

Hydrea X X X X X X X X X X

hydromorphone chronic pain X

hydroxychloroquine

lupus, rheumatoid arthritis, Sjogren's syndrome

X X X X X X

hydroxyurea X X X X X X X X X X

hylan G-F 20 X

Ibrance X X

Ilozyme X X

imatinib X X X X X X X X X X

immune globulin X

Imuran X X X X

17

Medicare Supplement





Home Care Plus

Hospital Indemnity


Recovery Care

Continental Care


Home Care

Drug name Condition


Back to top

Inderal heart or artery disease X

Inderal + blood thinner


X

indinavir X

infliximab X

InnoPran + blood thinner


X

Inspra X

insulin X

insulin (unit limits vary by product. see application)

X X X X

interferon alfa-2a X X X X X X X X

interferon alfa-2a hepatitis X X

interferon alfa-2b X X X X X X X X X X X

interferon beta X X X X X X

interferon beta multiple sclerosis X

interferon gamma X X X X X X

interferon gamma-1b X

Intron A X X X X X X X X X

Intron A hepatitis X X

Invega X X X X X X

18

Medicare Supplement





Home Care Plus

Hospital Indemnity


Recovery Care

Continental Care


Home Care

Drug name Condition


Back to top

iodine l 131 X

Iressa X X X X X X X X X X

Isentress X X X X X X X X X X

Isoptin + blood thinner


X

Iveegam X

Jakafi X X X X X X X X X

Jantoven X

Jantoven heart or artery disease X

Kadian X

Kemadrin Parkinson’s disease X X X X X X X

Keytruda X X X X X X X X X

Kineret X

Kutrase X

Ku-Zyme X

Lamictal X

lamivudine/zidovudine X

lamotrigine X

Lanoxicaps


X X

Lanoxicaps heart or artery disease X

19

Medicare Supplement





Home Care Plus

Hospital Indemnity


Recovery Care

Continental Care


Home Care

Drug name Condition


Back to top

Lanoxin


X

Lantus X

Lantus (unit limits vary by product. see application)

X X X X

Lapase X X

Larodopa Parkinson’s disease X X X X X X X

Lasix (40mg or more) X X X

Lasix (any amount) congestive heart failure X X X

Latuda X X

Lazanda X

ledipasvir X X

ledipasvir hepatitis X X

leflunomide X

Lemtrada X

lenalidomide X X X X X X X X X

letrozole X X X X X X X X X X

Leukeran X X X X X X X X X X X

leuprolide X X X X X X X X X X

levodopa Parkinson’s disease X X X X X X X

Lioresal multiple sclerosis X X X X X X X

Lipram X X

20

Medicare Supplement





Home Care Plus

Hospital Indemnity


Recovery Care

Continental Care


Home Care

Drug name Condition


Back to top

Lithane X X X X X X

lithium X X X X X X

Lithobid X X X X X X

Lodosyn Parkinson’s disease X X X X X X X

lomustine X X X X X X X X X X X

Lopressor + blood thinner


X

loxapine X X X X X X

Loxitane X X X X X X

Lupron X X X X X X X X X X

lurasidone X

Lysodren X X X X X X X X X X

Mab Thera X

Magnacet X

marijuana X

Marinol X X X

Matulane X X X X X X X X X X X

mechlorethamine X X X X X X X X X X

Megace X X X

Megace X X X X X X X X X

megestrol X X X

megestrol X X X X X X X X X

Mellaril X X X X X

21

Medicare Supplement





Home Care Plus

Hospital Indemnity


Recovery Care

Continental Care


Home Care

Drug name Condition


Back to top

melphalan X X X X X X X X

melphalan multiple myeloma X X

memantine X X X X X X X X X

Mepergan X

meperidine X

mercaptopurine (6-MP) X X X X X X X X X X

mesoridazine X X X

Mestinon X X X X X

Metanx X

methadone X X X

Methadose X X X

methotrexate X X X X X X X X X X

metolazone X

metoprolol + blood thinner


X

Mexate X X X X X X

Mirapex Parkinson’s disease X X X X X X X

Mithracin X X X X X X X X X X

mitomycin X X X X X X X X X X

mitotane X X X X X X X X X X

Moban X X X X X X

Moderiba X X

Moderiba hepatitis X X

22

Medicare Supplement





Home Care Plus

Hospital Indemnity


Recovery Care

Continental Care


Home Care

Drug name Condition


Back to top

molindone X X X X X X

morphine X

M-Oxy X

MS Contin X

Multaq X

Multaq heart rhythm disorder X

Mustargen X X X X X X X X X X

Mutamycin X X X X X X X X X X

mycophenolate mofetil X X X X

Mykrox X

Myleran X X X X X X X X X X

Mylocel X

Mylotarg X X X X X

Myochrysine X

Mytelase X X X X X

naloxone X X X

naltrexone X X X X

Namenda X X X

Namenda X X X X X X

Namzaric X X X X X

Nardil X X X X X X

Navane X X X X X X

Nebupent X X X X X X

Nebupent X

23

Medicare Supplement





Home Care Plus

Hospital Indemnity


Recovery Care

Continental Care


Home Care

Drug name Condition


Back to top

Neoral X X X X

Neosar X

neostigmine X X X X X

Neulasta X X X

Neupogen X X X

Neupro Parkinson’s disease X X X X X X

Nexterone heart rhythm disorder X

Nilandron X X X X X X X X X X

nilutamide X X X X X X X X X X

nivolumab X X X X X X X X X X

novo-amiodarone heart rhythm disorder X

Novolog X

Novolog (unit limits vary by product. see application)

X X X X

Numorphan X

Octagam X X X

octreotide X X

olanzapine X X X X X X

Oncovin X X X X X X X X X

Onsolis X

Onxol X X X X X

Opana X

Opdivo X X X X X X X X X X

24

Medicare Supplement





Home Care Plus

Hospital Indemnity


Recovery Care

Continental Care


Home Care

Drug name Condition


Back to top

Orap X X

Orencia X

Ormazine X

orphenadrine X X X

Otezla X

Otezla X

oxaliplatin X X X X X X X X X X

Oxecta X

oxycodone X

Oxycontin X

Oxygen X X X

oxymorphone X

Pacerone X

Pacerone heart rhythm disorder X

paclitaxel X X X X X X X X X X X

palbociclib X X

Palcaps X X

paliperidone X X X X X X

pamidronate X X X X X X X X X X

Panase X X X X

Pancrease X X X X

Pancreaze X X X X

Pancrecarb X X X X

pancrelipase X X X X

25

Medicare Supplement





Home Care Plus

Hospital Indemnity


Recovery Care

Continental Care


Home Care

Drug name Condition


Back to top

Pancron D/R X X X X

Pangestyme X X X X

Panocaps X X X X

Panokase X X X X

Papaconcirculatory disease w/ diabetes

X X

papaverine X

papaverinecirculatory disease w/ diabetes

X X

Parcopa Parkinson’s disease X X X X X X

paricalcitol

CKD, kidney failure, renal insufficiency, dialysis/kidney disease

X X X X X X X X X X

Parlodel X X X X X X X X

Pavabid X

Pavabidcirculatory disease w/ diabetes

X X

Pavacotcirculatory disease w/ diabetes

X X

Pavagencirculatory disease w/ diabetes

X X

pegfilgrastim X X X X X X X X X X

peginterferon X X X

26

Medicare Supplement





Home Care Plus

Hospital Indemnity


Recovery Care

Continental Care


Home Care

Drug name Condition


Back to top

PegIntron X X X

PegIntron hepatitis X X

pembrolizumab X X X X X X X X

Pentam X X X X X X X

pentamidine X X X X X X X

Pentopakcirculatory disease w/ diabetes

X X

pentoxifylline X X

pentoxifylline

circulatory disease w/ diabetes, peripheral vascular, peripheral artery disease

X

Pentoxil X X

Pentoxilcirculatory disease w/ diabetes

X X

Percocet X

Permitil X

perphenazine X X X X

Pertzye X X X X

phenelzine X X X X X X

Phl-amiodarone heart rhythm disorder X

PhosLo X X X X X X X

Phoslyra X

27

Medicare Supplement





Home Care Plus

Hospital Indemnity


Recovery Care

Continental Care


Home Care

Drug name Condition


Back to top

pimozide X

Plaquenil


X X X X X X X

Plaretase X X X X

Platinol X X X X X X X X X X

Plavix heart or artery disease X

Plavix peripheral vascular disease X

Pletal X X

Pletalcirculatory disease w/ diabetes

X X

plicamycin X X X X X X X X X

Polygam S/D X

Pradaxa X

pramipexole Parkinson’s disease X X X X X X X

prednisone X

Primlev X

Privigen X

procarbazine X X X X X X X X X X X

prochlorperazine X X X X X

Procrit X X X X X X X X X

procyclidine Parkinson’s disease X X X X X X X

28

Medicare Supplement





Home Care Plus

Hospital Indemnity


Recovery Care

Continental Care


Home Care

Drug name Condition


Back to top

Prograf X X X X

Prolixin X X X X X X

promethazine HCl (Hydrochloride)

emphysema, COPD X

propafenone X

propafenone heart rhythm disorder X

propranolol peripheral vascular disease X

propranolol + blood thinner


X

Prostigmin X X X X X

Protilase X X

Prozacmajor depressive disorder, bipolar disorder

X

Purinethol X X X X X X X X X X

Purixan X X X X X X X X X

pyridostigmine X X X X X

quetiapine X X X X X X

Quineprox


X X X X X X X

Quin-G heart rhythm disorder X

29

Medicare Supplement





Home Care Plus

Hospital Indemnity


Recovery Care

Continental Care


Home Care

Drug name Condition


Back to top

Quinidex + blood thinner


X

quinidine + blood thinner


X

Quinora + blood thinner


X

raltegravir X X X X X X X X X X

Rapifluxmajor depressive disorder, bipolar disorder

X

rasagiline Parkinson’s disease X X X X X X X

Rayos X

Razadyne X X X

Razadyne X X X X X X

Rebetol X X

Rebif X X X X X X

Rebif multiple sclerosis X

Reclast

internal cancer, Paget’s diesase, multiple myeloma

X X X X X X X X X

Remicade X

Reminyl X X X X X X X X X

Renagel X X X X X X X

30

Medicare Supplement





Home Care Plus

Hospital Indemnity


Recovery Care

Continental Care


Home Care

Drug name Condition


Back to top

Renvela X X X X X

Requip Parkinson’s disease X X X X X X

Retrovir X X X X X X X X X

ReVia X X X

Revlimid X X X X X X X X X

RibaPak X

Ribasphere X

ribavirin X X

Ridaura X

Rilutek X X X X X X X X X

riluzole X X X X X X X X X

Risperdal X X X X X X

risperidone X X X X X X

Rituxan X X X X X

rituximab X X X

rivaroxaban X

rivastigmine X X X X X X X X X

Rocaltrol

CKD, kidney failure, renal insufficiency, kidney disease/kidney disease requiring dialysis

X X X X X X X X X X

Roferon-A X X X X X X X X

31

Medicare Supplement





Home Care Plus

Hospital Indemnity


Recovery Care

Continental Care


Home Care

Drug name Condition


Back to top

ropiniroleParkinson’s disease, multiple sclerosis

X X X X

ropinirole Parkinson's disease X X X X

rotigotine Parkinson’s disease X X X X X X

Roxanol X

Roxicet X

Roxicodone X

Rubex X

ruxolitinib X X

Rytary Parkinson's disease X X X X X X

Rythmol X

sacubitril and valsartan X

Sandimmune X

Sandostatin X X

Saphris X X

Sarafemmajor depressive disorder, bipolar disorder

X

Savaysa


X

Savaysa heart or artery disease X

Savelamer X

32

Medicare Supplement





Home Care Plus

Hospital Indemnity


Recovery Care

Continental Care


Home Care

Drug name Condition


Back to top

selegiline Parkinson’s disease X X X X X X X

Selfemramajor depressive disorder, bipolar disorder

X

Sensipar X X X X X X X X X

Serentil X X X X

Seroquel X X X X X X

sevelamer X X X X X X

Simponi Aria X

Sinemet Parkinson’s disease X X X X X X X

sofosbuvir X X X

sofosbuvir hepatitis X X

Soliris X

sotalol X

Stelara X

Stelazine X X X X X X

Stribild X X X X X X X X X X X

Suboxone X X X

Subsys X

Subutex X X X

sunitinib X X X X X X X X X

Supprelin X X

Sutent X X X X X X X X X

Sycrest X

33

Medicare Supplement





Home Care Plus

Hospital Indemnity


Recovery Care

Continental Care


Home Care

Drug name Condition


Back to top

Symbyax X X X X

Symmetrel Parkinson’s disease X X X X X X X

Syndros X X X

Synvisc X

Tabloid X X X X X X X X X X

tacrine X X X X

tacrolimus X X X X

Tambocor X

Tarabine X

Tarabine PFS X X X X

Tarceva X X X X X X X X X

Targretin X X X X X X X X X X

Taxol X X X X X X X X X X X X

Taxotere X X X X X X X X X X

tbo-filgrastim X

tenofovir HIV, Hepatitis B, AIDS or ARC X X X X X X X X X X X

Tenormin + blood thinner


X

Tensilon X X X X

teriparatide X

Teslac X X X X X X

testolactone X X X X X X

tetrabenazine X X X X X

34

Medicare Supplement





Home Care Plus

Hospital Indemnity


Recovery Care

Continental Care


Home Care

Drug name Condition


Back to top

thalidomide X

Thalomid X X

TheraCys X X X X X X X X X

thioguanine X X X X X X X X X X

Thioplex X X X X X X

thioridazine X X X X X X

thiotepa X X X X X X X X X X

thiothixene X X X X X X

Thorazine X X X X X X

ticagrelor X

Tice BCG, BCG Live X X X X X X X X X

Ticlid X

ticlopidine X

Tikosyn X

tocilizumab rheumatoid arthritis X

tofacitinib X

Toprol + blood thinner


X

toremifene X X X X X X X X X

torsemide


X X X X X X X X X X

tositumomab X X X X X X X X X X X

trastuzumab X X

35

Medicare Supplement





Home Care Plus

Hospital Indemnity


Recovery Care

Continental Care


Home Care

Drug name Condition


Back to top

Trelstar LA X X X X X X X X

Trental X X

Trental

peripheral vascular, peripheral artery disease

X

Triavil X X

trifluoperazine X X X X X X

Trihexane Parkinson’s disease X X X X X X

trihexyphenidyl Parkinson’s disease X X X X X X X

Trilafon X X X X X X

triptorelin pamoate X X X X X X X X

Truvada X X X X X X X X X X

Tylox X

Ultrase X

Ultresa X X

Urecholine X

Urso X X X X

ursodiol X X X X

Valcyte X X X

valganciclovir X X X X

Vantas X X

Velban X X X X X X X X X X X

VePesid X X X X X X X X X X

36

Medicare Supplement





Home Care Plus

Hospital Indemnity


Recovery Care

Continental Care


Home Care

Drug name Condition


Back to top

verapamil + blood thinner


X

Verelan + blood thinner


X

Viadur X X X X X X X X X X

Videx X X X

Videx X X X X X X X X

Viibryd major depressive disorder X

vilazodone major depressive disorder X X

vinblastine X X X X X X X X X X X

Vincasar X X X X X X X X X X

vincristine X X X X X X X X X X X

Viokace X

Viokase X X

Vio-Moore X

Vivitrol X X X X

warfarin


X

Wellferon X X X

Xarelto


X

37

Medicare Supplement





Home Care Plus

Hospital Indemnity


Recovery Care

Continental Care


Home Care

Drug name Condition


Back to top

Xeljanz X

Xeloda X X X X X X X X X X

Xenazine X X X X X

Xtandi X

Xtandi X

Zaroxolyn X

Zarxio X

ZDV X

Zelapar Parkinson’s disease X X X X X X X

Zemplar

CKD, kidney failure, renal insufficiency, dialysis/kidney disease

X X X X X X X X X X

Zenpep X X

Ziagen X

zidovudine X X X X

zidovudine, AZT X X X X X

ziprasidone X X X X X X

Zoladex X X X X X X X X X

zoledronic acid X X X X X X X X

Zometa X X X X X X X X

Zubsolv X

Zymase X X

Zyprexa X X X X X X

Zytiga X X

©2018 Aetna Inc. CGFLP04363

For agent use only. Not for public use

or distribution.

Aetna Health and Life Insurance CompanyAetna Health Insurance Company

Aetna Life Insurance CompanyAmerican Continental Insurance Company

Continental Life Insurance Company of Brentwood, Tennessee

Aetna Companies

Senior Supplemental Insurance

Franklin, Tennessee aetnaseniorproducts.com

800-264-4000

drug list...drug list information we provide this list of the most commonly prescribed medications...

Documents