PreventiveRx drug list (Enhanced Plan - Traditional Drug List)
A preventive drug list showing prescription medications included under the PreventiveRx benefit for the Enhanced (Traditional) plan; informs which preventive drugs may be covered at low or no cost to members. Affects providers prescribing and pharmacists dispensing for Anthem members on this plan.
No material clinical or coverage changes in this revision.
Coverage Criteria Summary
This PreventiveRx benefit excludes brand-name drugs that have a generic equivalent available. The drug list may not include every covered product and is subject to change; some products—including drugs used for cosmetic purposes—may be excluded from benefits. Members and providers should refer to the member's Certificate or Evidence of Coverage for plan-specific limitations and exclusions.
Continuous Glucose Monitors (CGMs) are not covered under this PreventiveRx benefit.
Provider Actions & Requirements
Documentation Required for Diabetic Supplies
Diabetic supplies (blood glucose meters, test strips, lancets) require a prescription to be covered under this benefit. Only blood glucose meters and test strips for Accu-Chek and FreeStyle products are covered. Continuous Glucose Monitors (CGMs) are not covered under this PreventiveRx benefit.
- Prescription required for diabetic supplies
- Only Accu-Chek and FreeStyle meters and test strips covered
- Lancets covered with prescription
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