If you have health insurance coverage, your medicines are most likely covered under a separate pharmacy benefit. The benefit lists prescription drugs, both generic and brand names, that it will cover in a list known as a formulary.
Two prescription benefit managers are dropping certain asthma and allergy drugs from their formularies in 2017. If you take these medicines and have your prescriptions covered by CVS Caremark or Express Scripts, other medicines will be substituted instead.
This chart covers changes from CVS Caremark:
Ventolin HFA
Xopenex HFA
ProAir RespiClick
Alvesco
Flovent
Pulmicort Flexhaler
Qvar
Breo
Ellipta Flexhaler
Dulera
Omnaris
Qnasl
Rhinocort Aqua
Veramyst
Zetonna
fluticasone spray
triamcinolone spray
Dymista
cromolyn sodium
olopatadine
Pataday
Pazeo
This chart covers changes for Express Scripts:
Xopenex HFA
ProAir RespiClick
Ventolin HFA
Asmanex HFA
Asmanex Twisthaler
Flovent Diskus
Flovent HFA
Pulmicort Flexhaler
Qvar
Omnaris
Veramyst
Zetonna
flunisolide spray
fluticasone spray
mometasone
Qnasl
If you have trouble paying for your allergy and asthma medicine, see What to Do If You Can't Afford Your Asthma Medicines. For some people, one option might be to switch to an insurance plan with a pharmacy plan you prefer.
Open enrollment deadlines start coming up soon. If you are buying insurance on the federal Health Insurance Marketplace, stay up-to-date with enrollment deadlines.
Comments (4)
@donnamarie How did the insurance appeal go?
@donnamarie - have you tried albuterol in nebulized form? I know it's not as portable as an inhaler.
Hi donnamarie,
Welcome to AAFA's asthma support community.
It is very frustrating that your insurance isn't covering the medication that works for you. AAFA has a blog with some tips for what you can do if you can't afford your asthma medicine. I also invite you to join our asthma support forum where you can get ideas and support from other dealing with asthma.
I have been on Ventolin for 7 years due to smoke inhalation scaring my lungs. I am pron to bronchitis and this is what my doctor has put me on. This year we have been denied 3 times from CVS stating FDA ruling. We have tried proair and proventin and they do not produce the results the doctor wants. I will not pay for something that does not work just because the insurance company says so. I can not afford $50 for one inhaler when I was getting 3 every 4 months for $35. I will go with out and if my husband needs to call 911 so be it. I will forward the bill to them to pay. I need this medicine. I am between a rock and hard place. Use proair and risk overdose in order for it to work or go without and take my chances of hospitalization. What do I do??? I am filing an appeal but I do not believe it will make a difference....This is bs as the mediciation we need is being taken away from us. Not all medicines work on everyone. EVERYONE is different, Please bring back my Ventolin for me.......