Prescription Drug List 2004

Oxford's Prescription Drug List contains prescription drugs
that may be covered under Oxford's Standard and Preferred Drug Plans.
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Please note that the listing of a drug product on our Prescription Drug List does not guarantee coverage as certain products are excluded due to benefit plan design limitations that are specific to Membersí individual or group benefits. >>Read more

If you have questions about this list, please view our Prescription Drug List frequently asked questions.

The Prescription Drug List is current at the time of release and is subject to change.

  • Prescription drug coverage varies dependent on a Member's plan. The fact that a drug is listed here does not guarantee coverage.
  • Please note that certain prescription drugs require precertification.
  • Diabetic supplies, including oral prescription agents, that are available through the Memberís base medical benefit will be subject to the applicable co-payment (cost share) noted on the Memberís Summary of Benefits.
Note: To assist our providers, the drugs in this formulary have been listed by both their generic name and brand name. The presence of a medication on this list does not guarantee that a generic version is available.