Skip Ribbon Commands
Skip to main content
 

 Excluded Drug List

 

Our prescription drug benefit features an open Preferred Drug List, in which the following drugs (or services) are excluded:

  • Dietary supplements (covered in certain circumstances under the Durable Medical Equipment (DME) benefit)
  • Therapeutic devices or appliances (except where noted) (covered in certain circumstances under the Durable Medical Equipment (DME) benefit)
  • Biologicals, immunization agents, or vaccines (covered under the medical benefit)
  • Blood or blood plasma (covered under the medical benefit)
  • Medications which are to be taken by or administered to an individual, in whole or in part, while he or she is a patient in a licensed hospital, nursing home, or similar institution which operates on its premises or allows to be operated on its premises, a facility for dispensing pharmaceuticals (covered under the medical benefit)
  • Charges for administration or injection of any drug (covered under the medical benefit)
  • If an FDA-approved generic drug is available, the brand- name equivalent is not covered
  • Anabolic steroids
  • Progesterone supplements
  • Fluoride supplements/vitamins over age 13 except for prenatal vitamins
  • Drugs whose sole purpose is to promote or stimulate hair growth or for cosmetic purposes only
  • Drugs labeled "Caution-limited by federal law to investigational use," or experimental drugs, even though a charge is made to the individual
  • Medications for which the cost is recoverable under Worker's Compensation or Occupational Disease Law, or any state or government agency, or medication furnished by any other drug or medical service for which no charge is made to the member
  • Any prescription refilled in excess of the number of refills specified by the physician, or any refill dispensed after one year from the physician's original order

For more information about NHP's Preferred Drug List, call the NHP Customer Care Center at 800-462-5449.