Pharmacy Information

Note: The information appearing in this resource is intended to be a general guide to the costs and choices available under your prescription drug plan. The actual coverage may vary. Please refer to your specific plan benefit information for more detail. If you need to speak with a representative, please call AultCare Customer Service at 330-363-6360 or 1-800-344-8858.

Resources

 

AultCare offers our members an open formulary design (which means that the health plan may cover the costs of drugs that are not on the formulary list). Therefore, tier exceptions are not applicable. For example, a higher tier (Non Preferred) medication may not be requested at a lower tier (Preferred) co-pay.

Mail Order Pharmacy

 

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Brand name medications that now have generic equivalents available.

 
* All strengths & dosage forms may not be available (Generic name in parenthesis) *
Abilify
(Aripiprazole)
Exforge
(Amlodipine/Valsartan)
Intuniv
(Guanfacine)
Generess FE
(Norethindrone/Eth Estradiol/FE)
Nexium
(Esomeprazole)
Protopic Ointment
(Tacrolimus ointment)
Vivelle-DOT
(Estradiol patch)
Tarka
(Trandolapril/Verapamil)
Colcrys
(Colchicine)
Mirapex ER 0.75 mg, 1.5 mg
(Pramipexole ER)
Valcyte
(Valganciclovir)
Celebrex
(Celecoxib)
Actonel 150 mg
(Risedronate)
Baraclude
(Entecavir)
Vigamox ophth soln
(Moxafloxacin ophth soln)
Patanase spray
(Olopatadine spray)
Stromectol
(Ivermectin)

Note: Certain medications may be covered under medical, require prior authorization and/or may have plan limitations. Please call the AultCare Service Center at 330-363-6360 or 1-800-344-8858, if you have questions or if you need a pharmacy listing.