Customer Service
1-800-247-2583
Home

Preferred Brand Name Drug List

 

Preferred Brand Name Drugs (BCBSVT/TVHP Tier 2)

Updated 2-01-2013 (Effective 3-01-2013)

Drugs marked with an asterisk (*) are not covered under Catamount Blue.

 

A

ABILIFY

ACIPHEX

ACTONEL
ADDERALL XR

AGENERASE

ALINIA

ALPHAGAN P
ANDRODERM

ANDROGEL

APRISO
ATRIPLA

AXIRON
AZILECT

B
BD INSULIN NEEDLES

BD INSULIN SYRINGES

BENICAR
BENICAR HCT
BETASERON
BRAVELLE*

BYETTA

BYDUREON

C
CANASA
CARAC
CEENU
CELEBREX
CETROTIDE*
CIPRODEX
CLIMARA PRO
COMBIVENT
COMBIVIR
CONDYLOX GEL
COPAXONE
CORTIFOAM
CREON

CRESTOR
CRIXIVAN
CUPRIMINE

CYMBALTA

D
DAPSONE
DEPAKOTE SPRINKLE CAP 125MG

DETROL LA
DILANTIN KAPSEALS*

DUAC CS KIT

DULERA

E
EDURANT

ELMIRON
EMCYT
ENBREL
ENTOCORT EC
EPIPEN
EPIVIR -HBV
EPZICOM
ERGAMISOL
ERIVEDGE

ESTRADERM
ESTRATEST
ESTRATEST HS
EVISTA
EVOXAC
EXELON

F
FARESTON
FINACEA
FLOVENT
FORTOVASE

FREESTYLE GLUCOMETER
FREESTYLE TEST STRIPS

G
GENOTROPIN
GLEEVEC
GLUCAGON

GOLYTELY

H
HEPSERA
HEXALEN
HIVID
HUMALOG
HUMIRA
HUMULIN

I
INCIVEK

INNOPRAN XL
INTAL INHALER
INTRON A
INVIRASE

J
JANUMENT

JANUVIA

JEVTANA

K
KALETRA, capsule and solution

KYPROLIS

L

LANTUS

LETARIS
LEUKERAN
LEVEMIR
LEXIVA
LIDODERM
LOTEMAX
LUNESTA
LYSODREN

M
MEPHYTON
METHERGINE

MIGRANAL
MYLERAN

N
NAMENDA
NASONEX
NEUPOGEN
NEXAVAR
NIASPAN
NILANDRON
NORDITROPIN
NORVIR

NOVOFINE (syringes & needles)
NUVARING

O
ONE TOUCH GLUCOMETER
ONE TOUCH TEST STRIP
OXSORALEN ULTRA
OXYTROL

P
PEGASYS
PICATO

PLAN B
PRANDIN
PRECISION GLUCOMETER
PRECISION TEST STRIPS
PRED MILD
PREMARIN
PREMARIN CREAM
PREMPHASE
PREMPRO
PREVEN
PREZISTA

PROAIR

PROAIR HFA
PROCRIT

PRODIGY (syringes & needles)
PULMICORT RESPULES
PULMOZYME

Q
QVAR

R
RAPAMUNE
REBETRON
REBIF
RENAGEL

RESCRIPTOR
RESTASIS
REVLIMID
REYETAZ
RIDAURA


S
SAVELLA

SEREVENT

SEREVENT DISKUS 
SPIRIVA
SPRYCEL
STALEVO

SUBOXONE SL FILM #
SUSTIVA
SUTENT

SYLATRON

SYMBICORT

SYNVISC (All Formulations)

T
TARCEVA

TARGRETIN
TAZORAC
TEMODAR
TESLAC
THIOGUANINE I
TOBI

TRACLEER

TRADJENTA

TRAVATAN Z
TREXALL

TRICOR TABS (48MG & 145MG)

TRIZIVIR
TRUVADA

TYKERB
TYZEKA

U
ULTRASE
ULTRASE MT

V
VENTOLIN HFA

VEPESID
VIAGRA*
VIDEX
VIRACEPT
VIRAMUNE
VIREAD
VIVELLE
VOTRIENT

VYVANSE

W
WELCHOL

X
XALATAN
XELODA
XENICAL

XIFAXAN (550 mg)

Y

YERVOY

Z

ZOLADEX
ZOLINZA
ZYPREXA

ZYTIGA