Excluded Drug List / Coverage Exclusions
A list of specific drugs within therapy classes that are excluded from coverage and suggested alternatives; applies to HealthPartners members and their providers seeking coverage information.
No material clinical or coverage changes in this revision.
Coverage Criteria
The Excluded Drug List identifies specific branded products and formulations that are not eligible for coverage. The list covers select drugs across multiple therapy classes and names individual agents that are excluded from member benefits.
Provider Actions & Notices
Coverage Exclusion Risk
The Excluded Drug List includes select drugs within a therapy class that are not eligible for coverage under certain member benefit plans. Drugs appearing on the Excluded Drug List may be ineligible for coverage — verify member benefits prior to prescribing or dispensing. Providers should consider clinically appropriate alternatives or submit a prior authorization request if available under the member's benefit plan.
Member Services Contact
For questions about a member's specific prescription drug benefits (including whether a drug is covered, member cost share, or coverage exceptions), contact Member Services using the phone number on the back of the member's ID card.
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