DIABETES (1 of 2) Metformin CVS (State Healthcare Generic (30 days) (Evercare) Glucophage $14 (500mg) metformin (Walmart $4) $ not avail Glucophage XR metformin ER (Walmart $4) Metaglip metformin/glipizide Glucovance metformin/glyburide Sulfonylurea CVS (State Healthcare Generic (30 days) (Evercare) glimepiride (Walmart $4) Glucotrol glipizide (Walmart $4) Glucotrol XL glipizide ER Micronase, glyburide (Walmart $4) glyburide $11 Generic micronized (Walmart $4) TZD/Others CVS (State Healthcare Generic (30 days) (Evercare) ACTOplus Bydureon Janumet XR Kombiglyze XR saxagliptin/metformin
AlohaCare: Actos, Duetact, ACTOplusmet - trial of metformin or metformin/combination drugs in last 60 days
HMSA Quest: Actos - recent 60d trial of metformin or sulfonylurea. Actoplus met and Duetact - recent 30d of Actos AND metformin/glimepiride. Januvia/Janumet/XR - recent 60d trial of metformin and sulfonylurea Highlighted - - covered by all 6 plans January 2014 v30 p. 11 DIABETES (2 of 2) CVS (State Costco $ Generic Aloha employees Healthcare Generic (10 ml vial) (Evercare) vial, pen vial, pen vial, pen vial, pen Humalog Mix vial, pen Humalog Mix vial, pen Humulin 70/30 NPH/reg mix vial, pen Humulin N vial, pen Humulin R $207 vial, Lantus (vial) vial, pen vial, pen vial, pen vial, pen Novolin 70/30 NPH/reg mix (int/reg) $ not avail Novolin N Novolin R vial, pen Novolog 70/30 vial, pen
*HMSA Quest. Insulins - says which which insulin is covered, but not if both vial and pen forms are covered. Glucometers Costco $ Generic CVS (State Healthcare (10 ml vial) (Evercare) Accu-Chek Aviva Plus, Accu-Chek Compact Plus Bayer Breeze 2/ Bayer Contour Freestyle Lite/ Freestyle Freedom Lite One touch ultra (Ultra 2 or Ultra mini)
Ohana - glucometer. Website and customer service both say accu-chek and freestyle covered, but pharmacists tell us onetouch glucometer/lancets covered but NOT test strips. **UHC Evercare: Covers Bayer Breeze/Contour glucometer. For One Touch & Accu-Chek, covers test strips but need to call manufacturers directly for free glucometer. Accu-Chek - call 877-411-9833. One Touch - call 1-800-285-9814, order code 596UHC100. Covered test strips: one-touch ultra test strips (50 or 100), One Touch Delica Lancets (used with One Touch Ultra 2 Meter), One Touch Ultrasoft lancets (used with older One Touch Ultra Meters). Non-insulin diabetics allowed once daily testing only. No longer covers Bayer test strips.
***CVS State employees: Accu-Chek or One Touch glucometers- call 1-800-588-4456.
*Free glucometer from manufacturer : www.accu-chek.com, www.bayercontour.com, www.freestylepromise.com, www.onetouch.com
January 2014 v30 p. 12
FOR TOPICAL USE ON THE FACE ONLYWhat is the Most Important Information about ReFissa [Tretinoin Cream, USP (Emollient) 0.05%]?ReFissa is a serious medication. It does not eliminate wrinkles or repair sun-damaged skin. It may help treat fine wrinkles, spotty discoloration, and rough feeling skin, but it does not “cure” these conditions. ReFissa should only be used under supervision of your
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