2017 New Hampshire Select Drug List
Search by medication name for up-to-date drug information, including the benefit tier your drugs are on, as well as applicable clinical edits such as prior authorization or step therapy requirements.
You can also view the full drug list here. (Some pages of this document are intentionally left blank.)
Your coverage has limitations and exclusions, which means that some drugs on this list may not be covered, depending on your plan’s design. To find out more, please refer to your Certificate/Evidence of Coverage or your Summary Plan Description.
To our providers: Click here to initiate an electronic prior authorization (ePA) request.