Pharmacy Benefit Updates Since Your Last Issue

Dean Health Plan (DHP) has a PDF document that lists all the formulary medications and their corresponding tier level. You can search the document easily by clicking the binocular icon on your toolbar. You can find this list at www.deancare.com. Click on “Dean Health Plan,” then “For Members,” then “Pharmacy Information,” then “Drug Formulary.”

The pharmacy information Website has two additional lists that may be viewed online: the Drug Prior-Authorization List, which includes drugs restricted to certain specialists, and the Drug Exclusion List. You can also call Customer Service at 608-828-1301 or 800-279-1301 for a complete copy of either list or for more information about your prescription drug benefit.

Drug Prior-Authorization List

The medications on this list require prior authorization (PA) by DHP. Brand names are listed first, with the generic name in parentheses.

Added to PA List

Lyrica (pregabalin)

Removed From PA List

Forteo (teriparatide)
Sensipar (cinacalcet)
Topamax (topiramate)

Drugs Restricted to Certain Specialists (RS)

The drugs below are covered only when prescribed by the following specific specialties. Submission of prior authorization is not required for the specialties indicated. These drugs are not available for all other specialties.

Added to RS List

Forteo (teriparatide): endocrinology, gynecology or rheumatology clinicians
Sensipar (cinacalcet): endocrinology or nephrology clinicians
Topamax (topiramate): headache or pain specialists, or neurology or psychiatry clinicians

As drugs are approved by the FDA, we may add them to this list. Your physician or your pharmacist should fill out a Drug Prior-Authorization Request Form. For urgent authorizations, your physician should call Customer Service.

Drug Exclusion List

Our drug benefit does not automatically cover every new drug that the FDA approves. Our panel of physicians evaluates new drugs. If an excluded drug has been prescribed for you, ask your physician or pharmacist if he or she can substitute it with one of the medications that we cover. Brand names are listed first, with the generic name in parentheses.

Recently Excluded

Azmacort (triamcinolone acetonide)*
Qvar (beclomethasone dipropionate HFA)*

Removed From Excluded List and Now Covered in Tier 2

Nevenac (nepafenac)

General exclusions: Nonprescription over-the-counter drugs, weight-loss products, drugs for cosmetic use and oral medications for the treatment of sexual dysfunction

*Not covered under the two-tier pharmacy benefit; covered under the threetier pharmacy benefit

Back to Top