Badgerrxgold.com

BadgerRx Gold Covered Medications
This is an abridged list of commonly used brand and generic medications covered for BadgerRx Gold members. This list represents only a portion of the total list of covered medications. You may review the entire medication list at www.badgerrxgold.com or discuss your questions with a customer service representative toll-free at 866-809-9382 (8:30am to 5:00pm Central time, M-F). ADHD/ ANTI-NARCOLEPSY/
ANTI-OBESITY/
ANOREXIANTS
CONTRACEPTIVES
ANTIDIABETICS
AMINOGLYCOSIDES
ANTI-INFECTIVE AGENTS -
ANALGESICS -
DERMATOLOGICALS
ANTI-INFLAMMATORY
ANTINEOPLASTICS AND
ADJUNCTIVE THERAPIES
ANALGESICS - OPIOID
ANTIPARKINSON AGENTS
ANTIPSYCHOTICS/
ANTIMANIC AGENTS
DIAGNOSTIC PRODUCTS
ANTIANXIETY AGENTS
ANTIARRHYTHMICS
ANTIASTHMATIC AND
ANTIEMETICS
ANTIVIRALS
BRONCHODILATOR AGENTS
ANTIFUNGALS
BETA BLOCKERS
ANTIHYPERLIPIDEMICS
DIURETICS
ANTICOAGULANTS
CALCIUM CHANNEL
BLOCKERS
ANTICONVULSANTS
ENDOCRINE AND
METABOLIC AGENTS -
(QL= 1 tab/day; 10/80mg tab is Not Covered) ANTIHYPERTENSIVES
ANTIDEPRESSANTS
CEPHALOSPORINS
NC Not Covered
generic =small letters
BRANDS =CAPITAL LETTERS
Discounts may not apply who exceed 300% FPL Available through Specialty Pharmacy Program BadgerRx Gold Covered Medications
This is an abridged list of commonly used brand and generic medications covered for BadgerRx Gold members. This list represents only a portion of the total list of covered medications. You may review the entire medication list at www.badgerrxgold.com or discuss your questions with a customer service representative toll-free at 866-809-9382 (8:30am to 5:00pm Central time, M-F). (QL= 9 tabs/fill; 2 fills/30 days) ESTROGENS
(QL= 9 tabs/fill; 2 fills/30 days) (QL= 9 tabs/fill; 2 fills/30 days) NASAL AGENTS - SYSTEMIC
FLUOROQUINOLONES
AND TOPICAL
HEMATOLOGICAL AGENTS -
HYPNOTICS
OPHTHALMIC AGENTS
MACROLIDES
MEDICAL DEVICES
OTIC AGENTS
PENICILLINS
PSYCHOTHERAPEUTIC AND
NEUROLOGICAL AGENTS -
ULCER DRUGS
MIGRAINE PRODUCTS
URINARY ANTISPASMODICS
(QL= 9 tabs/fill; 2 fills/30 days) (QL= 9 tabs/fill; 2 fills/30 days) (QL= 9 tabs/fill; 2 fills/30 days) VASOPRESSORS
(QL= 6 sprays/fill; 2 fills/30 days) NC Not Covered
generic =small letters
BRANDS =CAPITAL LETTERS
Discounts may not apply who exceed 300% FPL Available through Specialty Pharmacy Program

Source: http://www.badgerrxgold.com/resources/badgerrxgoldqr012014.pdf

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