Category

Coverage Policy

Agents used for cosmetic purpose or hair growth

Not covered

Agents used for plantar warts

Covered:

Agents used to promote smoking cessation

All smoking cessation products are covered.

Analgesics – OTC

Covered:

Antacids and antigas – OTC

Covered:

Antidiarrheal – OTC

Covered:

Antihistamine and decongestant combinations

Covered:

Antihistamines (OTC)

Covered:

Antiseptics

Covered:

Barbiturates

Covered

Benzodiazepines

Covered

DESI and IRS drugs
Product case examples:
Midrin
Estratest

DESI and IRS drugs are FDA designations related to “substantial evidence” of effectiveness. MHCP does not cover designation values 4 and 5.

Drugs used to promote weight loss

Not covered

Eye – Ear – Nose – Mouth

Covered:

Laxatives

Covered:

Miscellaneous – OTC

Covered:

Pediculocides

Covered:

Symptomatic relief of cough and colds

Legend and OTC drugs listed in Pharmacy Services are covered.

Covered:

Topical and vaginal antifungals

Covered:

Topicals, misc.

Covered:

Vitamins, minerals and electrolytes
(Some specific brands may not be covered)