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Minnesota Health Care Programs
Drug Search: adderall xr 30 mg capsule,extended release
2 drug(s) found
To view other medications in a therapeutic class, click any class hyperlink in your search results.

Results

Brand Name
Generic Name		Therapeutic Class
Sub-Class		Dose/StrengthStatusNotes & Restrictions
DEXTROAMPHETAMINE-AMPHETAMINE ER 30 MG 24HR CAPSULE,EXTEND RELEASE
Behavioral Health
Attention Deficit/Hyperactivity Disorder (Adhd)		Behavioral Health
Attention Deficit/Hyperactivity Disorder (Adhd)		CAPSULE,EXTENDED RELEASE 24HR 30 mg
ADDERALL XR 30 MG CAPSULE,EXTENDED RELEASE
dextroamphetamine-amphetamine er 30 mg 24hr capsule,extend releaseBehavioral Health
Attention Deficit/Hyperactivity Disorder (Adhd)		Behavioral Health
Attention Deficit/Hyperactivity Disorder (Adhd)		CAPSULE,EXTENDED RELEASE 24HR 30 mg

Definition of Status

IconStatusDefinition
Formulary Generic - Low Cost GenericFormulary Generic - Low Cost GenericMedicines marked with this symbol are generic medicines and are included on the list of medicines (formulary) covered by your pharmacy benefits. Generic medicines are just as safe and effective as brand medicines but cost you less money. Medicines with this symbol are very low-cost. Depending on your plan, these medicines might be covered at the lowest copay or coinsurance.
Formulary Generic - High CostFormulary Generic - High CostMedicines marked with this symbol are generic medicines and are included on the list of medicines (formulary) covered by your pharmacy benefits. Generic medicines are just as safe and effective as brand medicines but cost you less money. Depending on your plan, these medicines might be covered at a lower copay or coinsurance than brand medicines, but cost slightly more than the lowest-cost generic medicines.
Formulary BrandFormulary BrandMedicines marked with this symbol are brand medicines and are included on the list of medicines (formulary) covered by your pharmacy benefits. Brand medicines are more expensive than generic medicines. Depending on your plan, these medicines might be covered at a higher copay or coinsurance than generic medicines.
Non-Formulary Non-Formulary Medicines marked with this symbol are not on the formulary (list of covered medicines). Depending on your plan, these medicines might not be covered unless you get approval from HealthPartners or they might be covered at your higher copay or coinsurance.
ExcludedExcludedMedicines marked with this symbol are not eligible for coverage by most plans. Log on to your secure myHealthPartners account and click on "My plan benefits" on the Medical Plan tab to check your benefits for this type of medicine.

Medicines marked with this symbol are not eligible for coverage by most plans. Log on to your secure myHealthPartners account and click on "My plan benefits" on the Medical Plan tab to check your benefits for this type of medicine.
Medicines marked with this symbol are not eligible for coverage by most plans. Log on to your secure myHealthPartners account and click on "My plan benefits" on the Medical Plan tab to check your benefits for this type of medicine.
Growth HormoneGrowth HormoneProducts marked with this symbol are growth hormones. Growth hormone may not be covered under all contracts. Log on to your secure myHealthPartners account and click on "My plan benefits" on the Medical Plan tab to check your benefits for growth hormone. Click here to view the complete list of products covered by your growth hormone benefit and the pharmacy where you can fill your prescription.
Diabetes SuppliesDiabetes SuppliesProducts marked with this symbol are used for glucose testing. Approved products are covered under your durable medical equipment or DME benefit and can be purchased through any network pharmacy.

Click here to view the list of blood glucose testing products and other related benefit information.
Medical BenefitMedical BenefitMedicines marked with this symbol are not on the formulary, but may be covered under your medical benefit. This medicine may also require you to meet certain criteria before it is covered. Click here or log on to your secure account to check if there are medical coverage criteria for this medicine.
Over-the-CounterOver-the-CounterMedicines marked with this symbol are available over-the-counter (OTC). They are covered by your pharmacy benefits with a prescription from your doctor. 
Not CoveredNot CoveredMedicines marked with this symbol are not covered.
Not CoveredNot CoveredMedicines marked with this symbol are not covered.

Definition of Restrictions

IconRestrictionDefinition
Additional Coverage InformationAdditional Coverage Information

Additional coverage information is available for medicines marked with this symbol.
Age EditAge EditMedicines with this symbol are covered for people in a certain age range. This means if you're not in the approved age range,  you or your doctor will need to request approval from HealthPartners if you want your medicine to be covered by your pharmacy benefits.  The approval decision is usually made within 2 to 3 working days of the request.
Female OnlyFemale OnlyMedicines marked with this symbol are covered for females only. This means if you're not a female, you or your doctor will need to request approval from HealthPartners if you want your medicine to be covered by your pharmacy benefits.  The approval decision is usually made within 2 to 3 working days of the request.
Future coverage information Future coverage information

Future coverage information is available for medicines marked with this symbol.
Male OnlyMale OnlyMedicines marked with this symbol are covered for males only. This means if you're not a male, you or your doctor will need to request approval from HealthPartners if you want your medicine to be covered by your pharmacy benefits. The approval decision is usually made within 2 to 3 working days of the request.
Medical BenefitMedical Benefit

Medicines marked with this symbol are not on the formulary, but may be covered under your medical benefit. This medication may also require you to meet certain criteria before it is covered. Click here to search and view if there are medical coverage criteria for this medicine.
OncologyOncology

Prescriptions for this oncology (cancer) medicine must be filled at a specialty pharmacy, but are not subject to the specialty benefit. Your regular generic or brand pharmacy copay or coinsurance will apply.
Prior AuthorizationPrior Authorization

Medicines marked with this symbol require prior authorization. This means that you or your doctor will need to request approval from HealthPartners if you want your medicine to be covered by your pharmacy benefits. The coverage decision is usually made within 2 to 3 working days of the request.
Quantity LimitQuantity LimitMedicines marked with this symbol have a quantity limit. This means HealthPartners limits the amount of the medicine that you'll receive each time you fill your prescription.  The quantity limit may be less than the days supply listed in your contract or Summary Plan Description. 
Smoking Cessation Smoking Cessation
Medicines marked with this symbol are used for smoking cessation.

Medicines marked with this symbol are used for smoking cessation.
Medicines marked with this symbol are used for smoking cessation.
Medicines marked with this symbol are used for smoking cessation.
SpecialtySpecialtyPrescriptions for medicines marked with this symbol must be filled at a specialty pharmacy and are often covered at a different benefit than non-specialty medicines. Log on to your secure account to check your benefits for specialty medicines. Click here to view a complete list of specialty medicines and the pharmacy where you can fill your prescription.
Step TherapyStep TherapyMedicines marked with this symbol require step therapy.  This means HealthPartners will cover this medicine if you've already tried one or more other medicines on the formulary.  If you haven't tried the other medicine(s) first, you or your doctor will need to request approval from HealthPartners before this medicine will be covered by your lowest brand, generic or specialty copay or coinsurance.  The approval decision is usually made within 2 to 3 working days of the request.  Depending on your benefits, if this medicine is not approved, it will either not be covered or it will be covered by your higher copay or coinsurance.
Trial Drug Trial Drug Medicines marked with this symbol are in a trial drug program.  This includes new prescriptions for certain medicines that may not be well tolerated due to side effects, are high cost and/or high potential for waste. Your first 6 fills of a trial drug may be limited to less than a month supply. If the drug is well tolerated and effective, you'll receive the remainder of your month supply. If a flat dollar copay applies to the drug, you'll pay no more than one copay for each full one month supply.
Weight LossWeight Loss

Medicines marked with this symbol are used for weigth loss. Certain plans don't cover these medicines. Log on to your secure account to check your benefits for weight loss.