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Diabetic Sense To help meet the needs of members with diabetes, Catalyst Rx offers the Diabetic Sense Program. To enroll or learn more, please contact the Diabetic Sense National Diabetic Pharmacy at 1-877-852-3512.

Covered Drugs The following types of drugs and medical items are covered by the Plan.

Covered Drug

  • Legend Drugs and Legend Contraceptives

  • Compounded medication

  • Disposable blood/urine glucose/acetone testing agents

  • Disposable insulin needles/syringes

  • Glucagon



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Limitations/Requirements Federal law requires these drugs be dispensed by prescription only At least one ingredient must be a Legend Drug 1 Generic co-payment per 30 day supply

1 Generic co-payment per 30 day supply

1 Preferred brand drug co-payment per each single unit 1 Generic co-payment per 30 day supply 1 Generic co-payment per 30 day supply For individuals through the age of 20 years

What Drugs Are Not Covered? The following drugs and medical items are not

  • Anabolic steroids for muscle enhancement

  • Anorectics [any drug used for the purpose of weight loss]

  • Anti-wrinkle agents

  • Charges for administration or injection of any drug

  • Dietary supplements

  • Fluoride supplements

  • Hematinics

  • Impotency medications, unless related to organic disease

  • Infertility medications

  • Minerals

  • Medications for the termination of pregnancy (abortifacients)

  • Any medication not proven effective in general medical practice

  • Investigative drugs and drugs used other than for the FDA approved diagnosis

  • Immunizations for prevention of infectious diseases (e.g., measles, polio, flu, etc.) except through medical coverage under High Option for Children

  • Drugs prescribed by a provider not acting within the scope of his license

covered under the prescription drug program:

  • Drugs that do not require a written prescription

  • Medications for the treatment of alopecia

  • Non-legend drugs other than those listed as covered

  • Pigmenting/de-pigmenting agents

  • Drugs used for cosmetic purposes

  • Smoking deterrent medications containing nicotine or any other smoking cessation aids, all dosage forms

  • Therapeutic devices or appliances, including needles, syringes, support garments, and other non-medicinal substances, regardless of intended use, except those listed as covered above (some of these items may be covered under the Plan’s medical benefits)

  • Vitamins, singly or in combination (except legend prenatal vitamins)

  • Prescription drugs that have an equivalent product available over the counter

  • Refills in excess of the number specified by the physician or any refills dispensed more than one year after the date of physician’s original prescription.


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