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American Lung Association Report Appendix - State Health Insurance Marketplace Plans: New Opportunities for Helping Smokers QuitData collected January 15-February 11, 2015 unless otherwise noted. The American Lung Association will update this chart with new information as we are made aware of it. Please contact Jennifer.singleterry@lung.org if the information on a marketplace plan’s publically available formulary has been updated since February 11, 2015.Updated 8/24/15Chart KeyQL Quantity Limits; Listed in separate list linked to in the formulary; *Information found in document(s) separate from formulary; PA Prior authorization required; 0 Indicates 0 copay in formulary; ST step therapy; NA Not available; Not listed as smoking cessationListed on Formulary?StateAKAKALALALARARARNicotineMarketplace Type* Plan Issuer Name GumPremera Blue CrossFederallyBlue Shield offacilitatedAlaskaYesFederallyModa Health Blue Cross and BlueShield of Alabama YesUnitedHealthcareof Alabama, Inc.Yes0 l Spray InhalerBupropion Varenicline Link to formulary that was usedYesYesYesYesYesYes QL ?siteCode dfs/ak/pref drug list.pdfYesYesYesYesYes QLYes portal/forms/AuthorForms/IVL/2015 AL 635 StandardPrescriptionDL.pdfYes0 PAYes0 PAYes0 PA STYes0 PA ST Yes0 PAYes0 PA obal assets/Exchanges/4Tier%20Advantage%20PDL.pdfNew information obtained 4/22/15New information obtained 7/29/15Updated?Humana, Inc.QualChoice Life &Health InsuranceCompany, Inc.Celtic InsuranceCompanyYes0 Yes0 Yes0 Yes0 Yes0 Yes0 Yes0 e 2379728NoNoNoNoNoYesYes ducts%20and%20Services/essential formulary 2015.pdfYes0 QLYes0 QLYes0 QLNoYes0 QLYes0 QLYes0 New information obtained 4/28/15QC Life and HealthNoNoNoNoNoYesYes ducts%20and%20Services/essential formulary 2015.pdfPlan issuer name updated 4/28/15Arkansas Blue Crossand Blue 20abcbs%203-23-15.pdfAetna**Yes0 QLYes0 QLYes0 QLYes0 QLYes0 QLYes0 QLYes0 f/2015AetnaIndividualFiveTierClosedFormulary 4649 Full 690.pdfUnited Health OneBlue Cross BlueShield of Arizona,Inc.Cigna Health andLife InsuranceCompanyHealth ChoiceInsurance Co.Yes0 PAYes0 PAYes0 PAYes0 PA STYes0 PA ST Yes0 PAYes0 PA nsive/content/global assets/Exchanges/Essential%20PDL.pdfNew information obtained 4/28/15New information obtained and plannamed changed 6/1/15New information obtained4/27/2015Yes0Yes0Yes0Yes0 QLYes0Yes0 QLYes0 ation/2015mmittieredNew information obtained 4/28/15;new link posted 4/28/15Yes0 QLYes0 QLYes0 QLYesYesYes0 r-drug-list.cgi AND http://www.cigna.com/pdf/866548 d IFP PrevCoverage v1.pdf?WT.z nav MedicationNew information obtained oiceessential.com/members/rxdrugs.aspxNew information obtained 7/24/15Yes0Yes0Yes0Yes0Yes ected/pdfs/national/az essential rx list.pdfYes0Yes0Yes0Yes0Yes otected/pdfs/national/az essential rx list.pdfNew information obtained 4/28/15Plan issuer no longer listed onhealthcare.gov as of 4/28/15Health Net LifeInsurance Company Yes0Health Net ofArizona, Inc.Yes0Humana, Inc.Meritus HealthPartnersMeritus MutualHealth PartnersPhoenix HealthPlans, Inc.Yes0 Yes0 Yes0 Yes0 Yes0 Yes0 Yes0 e 2379728New information obtained 7/29/15Yes0 QLYes0 QLYes0 QLYes0 QLYes0 QLYes0 QLYes0 QLhttp://www.meritusaz.com/formulary.htmlNew information obtained 4/28/15Yes0 QLYes0 QLYes0 QLYes0 QLYes0 QLYes0 QLYes0 QLhttp://www.meritusaz.com/formulary.htmlNew information obtained 4/28/15Yes0 QLYes0 QLYes0 QLYes STYes STYes0 QLYes0 hoenix-choice-formularyNew information obtained 7/24/15Assurant HealthUniversity ofArizona HealthPlans-UniversityHealthcare, Inc.Yes QLNoYes QLYes QLYes QLYes QLYes dfPlan issuer name updated 4/28/15Yes QLYes QLYes QLYes QLYes QLYesYes UHM%20Formulary%20Jan%202015.pdfUpdated link posted 4/28/15New information obtained 8/23/15.Preventive services document states:Tobacco cessation products includingselect generic prescription drugs,select brand-name drugs withno generic alternative, and FDAapproved over-the-counter products.CAState-runCAState-runAnthem Blue Crossof CaliforniaYes0*Blue Shield ofCaliforniaYes0 QLCACACAState-runState-runState-runChinese CommunityHealth PlanYes0 QLHealth NetYes0Kaiser Permanente .com/ca/CASDL2015.pdf; https://www.anthem.com/ca/provider/f0/s0/t0/pw e232597.pdf; http://file.anthem.com/13019CAMENABC.pdfYes0 QLYes0 QLYes0 QLYes0 QLYes0 QLYes0 macy/Standard Formulary.pdfYes0 QLYes0YesYes0 QLYes0YesYes0 QLYes0NoYes0 QLYes0NoYes0 QLYes0Yes Yes0 fs/CCHP%20Exchange Complete ing/ifp/formsBrochures.action?group lth/pdfs/formulary/cal/2015 ca marketplace formulary.pdf
American Lung Association Report Appendix - State Health Insurance Marketplace Plans: New Opportunities for Helping Smokers QuitData collected January 15-February 11, 2015 unless otherwise noted. The American Lung Association will update this chart with new information as we are made aware of it. Please contact Jennifer.singleterry@lung.org if the information on a marketplace plan’s publically available formulary has been updated since February 11, 2015.Updated 8/24/15Chart KeyQL Quantity Limits; Listed in separate list linked to in the formulary; *Information found in document(s) separate from formulary; PA Prior authorization required; 0 Indicates 0 copay in formulary; ST step therapy; NA Not available; Not listed as smoking cessationListed on Formulary?StateCACACACACACOMarketplace Type* Plan Issuer NameL.A. Care HealthState-runPlanState-runMolina HealthcareState-runSharp Health PlanState-runValley Health PlanWestern HealthState-runAdvantageAccess eNicotineNasal Spray InhalerBupropion Varenicline Link to formulary that was usedYes0 QLYes0 QLYes PAYes0 QLYes0 QLYes0 QLYes PAYes0 QLYes0 QLYes0 QLYes PAYes0 QLYes0 QLYes0 QLYes PAYes0 QLYes0 QLYes0 QLYes PAYes0 QLYes0 QLYes0 QLYes QLYes0 QLYes0 QLYes0 QLYes PAYes0 sal/la care exchange complete formulary ealth.com/pdfs/provider-downloads/pdl-ca/Yes0 QLYes0 QLYes0 QLYes0 QLYes0 QLYes0 QLYes0 QLhttps://accesshealthco.com/members/formularyNew formulary link obtained7/24/2015Anthem Blue Crossand Blue angedruglist4.pdf; 0/t0/pw e232596.pdf; http://file.anthem.com/13019ANMENABS.pdfNew information obtained 8/23/15.Preventive services document states:Tobacco cessation products includingselect generic prescription drugs,select brand-name drugs withno generic alternative, and FDAapproved over-the-counter products.New information obtained 7/30/15CignaColorado ChoiceHealth PlansYes0 QLYes0 QLYes0 QLNoNoYes0 -drug-list.cgi AND http://www.cigna.com/pdf/866548 d IFP PrevCoverage v1.pdf?WT.z nav MedicationNoNoNoYes PA QLYes PA QLYes PA QLYes PA y.asp?var SLV&infoid ws.com/cohealthop/public/provider/cohealthop formulary all plans.pdfYes0Yes0 NoYes0Yes0 NoYes0Yes0 NoNoYes0 NoNoYes0 NoYes0Yes0 YesYes0 QL STYes0 cyState-runColorado HealthOPDenver HealthMedical PlanHumanaKaiser PermanenteRocky MountainHealth PlansNoNoNoYes PAYes PAYesYes PA s/good health formulary.pdf?sfvrsn 39New information obtained 7/24/15State-runUnitedYes0 PAYes0 PAYes0 PAYes0 PA STYes0 PA ST Yes0 PAYes0 PA nsive/content/global assets/Exchanges/Essential%20PDL.pdfNew information obtained 4/22/15http://file.anthem.com/40627CTMENABS.pdf; 0/t0/pw dfNew information obtained 8/23/15.Preventive services document states:Tobacco cessation products includingselect generic prescription drugs,select brand-name drugs withno generic alternative, and FDAapproved over-the-counter illness/smokingcessation.aspxNew information obtained .asp?file Yes0*Yes0 QLYes0*Yes0 QLNoYes0 QLNoYes0 QLNoYes0 QLYesYes0 QLYes0*Yes0 QLCTDCDCDCDCUnitedHealthcareAetna**Care FirstKaiserUnited HealthYes0 PAYes0 QLYes0NoNAYes0 PAYes0 QLYes0NoNAYes0 PAYes0 QLYes0NoNAYes0 PA STYes0 QLYes0NoNAYes0 PA STYes0 QLYes0YesNAYes0 PAYes0 QLYes0Yes NAYes0 PA STYes0 ntent/CT%203%20Tier%20Trad final.pdfAetna**Yes0 QLAetna Health Inc. (aPA corp.)NoHighmark BCBSDInc.YesYes0 QLYes0 QLYes0 QLYes0 QLYes0 QLYes0 f/2015AetnaIndividualFiveTierClosedFormulary 4649 Full 690.pdfYes QLNoYes QLYes QLYes QLYes ?siteCode rynavigator.com/Search.aspx?siteCode erallyfacilitatedFederallyfacilitatedAetna**Yes0 QLYes0 QLYes0 QLYes0 QLYes0 QLYes0 f/2015AetnaFLIndividualFiveTierClosedFormulary 5130 Full 831.pdfFLFederallyfacilitatedYes0 NoYesYesYes0 Yes0 ntent/MedGuide.pdfFLFederallyfacilitatedBlue Cross and BlueShield of FloridaYes0 Cigna Health andLife InsuranceCompanyYes0 QLYes0 QLYes0 QLYesYesYes0 QLYeshttp://www.cigna.com/ifp-drug-list AND http://www.cigna.com/pdf/866548 d IFP PrevCoverage v1.pdf?WT.z nav MedicationFLFederallyfacilitatedCoventry HealthCare of Florida, Inc. igator.com/Search.aspx?siteCode 5312228803DEDEYes0 QLNew information obtained 7/24/15New information obtained 7/24/15.Formulary specifies nicotine patch,gum and lozenge are available viathe state quitline.New information obtained /health/pdfs/formulary/col/co marketplace amaranrx.com/rxpublic/portal/memberMain?customer HCTNew information obtained es/pdf/2015AetnaIndividualFiveTierClosedFormulary 4649 Full mid/mid hmo formulary.pdfNew information obtained 6/1/15New information obtained 6/1/15New information obtained 7/30/15
American Lung Association Report Appendix - State Health Insurance Marketplace Plans: New Opportunities for Helping Smokers QuitData collected January 15-February 11, 2015 unless otherwise noted. The American Lung Association will update this chart with new information as we are made aware of it. Please contact Jennifer.singleterry@lung.org if the information on a marketplace plan’s publically available formulary has been updated since February 11, 2015.Updated 8/24/15Chart KeyQL Quantity Limits; Listed in separate list linked to in the formulary; *Information found in document(s) separate from formulary; PA Prior authorization required; 0 Indicates 0 copay in formulary; ST step therapy; NA Not available; Not listed as smoking cessationListed on Formulary?StateFLFLFLFLFLFLFLFLFLFLGAMarketplace neNicotineNasal Spray InhalerBupropion Varenicline Link to formulary that was usedNoNoNoNoYes its/2015-exchange-formulary.pdfYes0 QLYes0 QLYes0 QLYes0 QLYes0 QLYes0 QLYes0 QLhttp://www.healthfirsthealthplans.org/health plans/group/2015 sm grp 5 tier formulary.pdfNew information obtained 6/1/15Yes0 QLYes0 QLYes0 QLYes0 QLYes0 QLYes0 QLYes0 QLhttp://www.healthfirsthealthplans.org/health plans/group/2015 sm grp 5 tier formulary.pdfNew information obtained 6/1/15Health Options, Inc. Yes Yes y/Providers/Content/MedGuide.pdfHumana, Inc.Molina Healthcareof Florida, IncPreferred MedicalPlan, Inc.Sunshine StateHealth PlanYes0 Yes0 Yes0 Yes0 Yes0 Yes0 Yes0 e 2379728Yes0 QLYes0 QLYes0 QLYes0Yes0Yes0 QLYes0 pdfYes0 QLYes0 QLYes0 QLYes0 QLYes0 QLYes0 QLYes0 es0 QLYes0 QLYes0 QLNoYes0 QLYes0 QLYes0 QLhttp://ambetter.sunshinehealth.com/formularyNew information obtained 4/28/15Assurant HealthUnitedHealthcareof Florida, Inc.Yes QLNoYes QLYes QLYes QLYes QLYes dfPlan issuer name updated 4/28/15Yes0 PAYes0 PAYes0 PAYes0 PA STYes0 PA ST Yes0 PAYes0 PA obal assets/Exchanges/4Tier%20Advantage%20PDL.pdfNew information obtained 4/22/15Alliant Health Plans Yes0 QLYes0 QLYes0 QLYes0 QLYes0 QLYes0 lan Issuer NameFlorida Health CarePlan, Inc.Health First HealthPlans, Inc.Health FirstInsurance, Inc.Yes0 QLUpdated?New information obtained cbsga.com/GASelectdrugtier4; 0/t0/pw e232598.pdf; http://file.anthem.com/13019GAMENBGA.pdfNew information obtained 8/23/15.Preventive services document states:Tobacco cessation products includingselect generic prescription drugs,select brand-name drugs withno generic alternative, and FDAapproved over-the-counter products.Yes0 QLYes0 QLYesYesYes0 QLYeshttp://www.cigna.com/ifp-drug-list AND http://www.cigna.com/pdf/866548 d IFP PrevCoverage v1.pdf?WT.z nav MedicationNew information obtained rynavigator.com/Search.aspx?siteCode 5312228803Humana, Inc.Yes0 Kaiser FoundationHealth Plan ofGeorgiaNoPeach State HealthPlanYes0 QLYes0 Yes0 Yes0 Yes0 Yes0 Yes0 e 2379728NoNoNoYes STYes STYes th/pdfs/formulary/ga/ga qualified plan formulary 2014.pdfYes0 QLYes0 QLNoYes0 QLYes0 QLYes0 QLhttp://ambetter.pshpgeorgia.com/formularyNew information obtained 4/28/15Assurant HealthUnitedHealthcareof Georgia, Inc.Hawaii MedicalService AssociationKaiser PermanenteHawaiiAvera Health Plans,Inc.CoOportunityHealthCoventry HealthCare of Iowa Inc.Gundersen HealthPlan, Inc.Yes QLNoYes QLYes QLYes QLYes QLYes dfPlan issuer name updated 4/28/15Yes0 PAYes0 PAYes0 PAYes0 PA STYes0 PA ST Yes0 PAYes0 PA obal assets/Exchanges/4Tier%20Advantage%20PDL.pdfNew information obtained 4/22/15YesYesNoYes QLYes QLYes QLYes ary/hi/hi marketplace formulary 2014.pdfYes QLYes QLYes QLYes PANoYesYes com/Search.aspx?siteCode e-Cross-of-Idaho-QHP-Drug-Formulary.pdfYesYesYes0 PAYes0 15 3918 Full acificsource.com/drug-list/Blue Cross BlueShield HealthcarePlan of Georgia, Inc. Yes0*Cigna Health andLife InsuranceCompanyYes0 QLCoventry HealthCare of Georgia,Inc.NoBlue Cross of IdahoHealth Services, Inc. NoBridgeSpan HealthCompanyYesMountain Health CoOpNoPacificSourceHealth PlansYes0New information obtained 7/29/15
American Lung Association Report Appendix - State Health Insurance Marketplace Plans: New Opportunities for Helping Smokers QuitData collected January 15-February 11, 2015 unless otherwise noted. The American Lung Association will update this chart with new information as we are made aware of it. Please contact Jennifer.singleterry@lung.org if the information on a marketplace plan’s publically available formulary has been updated since February 11, 2015.Updated 8/24/15Chart KeyQL Quantity Limits; Listed in separate list linked to in the formulary; *Information found in document(s) separate from formulary; PA Prior authorization required; 0 Indicates 0 copay in formulary; ST step therapy; NA Not available; Not listed as smoking cessationListed on lace neLozengeNoNicotineNicotineNasal Spray InhalerYes QLYes QLBupropion Varenicline Link to formulary that was usedYes0 QLYes QLhttps://www.rxeob.com/PatientDashboard sh/advanced drug orms/IVL/2015 IL r.com/Search.aspx?siteCode rmularynavigator.com/Search.aspx?siteCode ance.org/content/pharmacy#formularyYes0 Yes0 Yes0 Yes0 Yes0 Yes0 e 2379728NoNoYesYesYes QLYes ile 2323880Yes0 QLYes0 QLNoNoYes0 QLYes0 QLhttp://marketplace.illinicare.com/formularyLand of LincolnMutual HealthInsurance Company Yes0 QLYes0 QLYes0 QLYes0 QLYes0 QLYes0 QLYes0 ns/formularyAssurant HealthNoYes QLYes QLYes QLYes QLYes dfPlan issuer name updated 4/28/15UnitedHealthcareof the Midwest, Inc. Yes0 PAYes0 PAYes0 PAYes0 PA STYes0 PA ST Yes0 PAYes0 PA nsive/content/global assets/Exchanges/Essential%20PDL.pdfNew information obtained 4/22/15Yes0 PAYes0 PAYes0 PAYes0 PA STYes0 PA ST Yes0 PAYes0 PA nsive/content/global assets/Exchanges/Essential%20PDL.pdfNew information obtained 4/27/15Plan Issuer NameSelectHealth, Inc.Blue Cross BlueShield of IllinoisCoventry Health &Life Co.Coventry HealthCare of Illinois, Inc.Health AllianceMedical Plans, Inc.Humana, Inc.Yes0 Humana InsuranceCompanyNoIlliniCare HealthPlan, Inc.Yes0 QLUnitedHealthcareYes QLAssurant HealthBlue Cross and BlueShield of KansasCityBlue Cross and BlueShield of Kansas,Inc.BlueCrossBlueShield KansasSolutions, Inc.Coventry Healthand LifeCoventry HealthCare Of Kansas IncNew information obtained 7/29/15Plan no longer listed onhealthcare.gov, .com/INSelectdrugtier4; http://file.anthem.com/13019ANMENABS.pdf; 0/t0/pw e232596.pdfNew information obtained 8/23/15.Preventive services document states:Tobacco cessation products includingselect generic prescription drugs,select brand-name drugs withno generic alternative, and FDAapproved over-the-counter products.Yes0 QLYes0 QLYes QLYes QLYes0 QLYes0 QLhttp://www.caresource.com/just4me/medsNew information obtained 6/1/15Yes0 QLYes0 QLYes0 QLNoYes0 QLYes0 QLYes0 ETTER-FROM-MHS PDL-2015 FINAL.pdfNew information obtained 4/27/15;new link posted 4/27/15Yes PAYes PAYes uals/formulary-directory/NoNoNoYes0 QLYes0Yes Yes0 PHPCompleteFormularyForExchange.pdfYes0 QLYes0 QLYes0 QLYes STYes STYes0 QLYes0 QLhttp://www.caremark.com/portal/asset/SIHO DrugList.pdfYes QLNoYes QLYes QLYes QLYes QLYes dfYes0Yes0Yes0Yes0NoYes 15 KS orForms/IVL/2015 KS t.formularynavigator.com/Search.aspx?siteCode rmularynavigator.com/Search.aspx?siteCode 5312228803Anthem InsCompaniesInc(Anthem BCBS) Yes0*CareSource Indiana,Inc.Yes0 QLCoordinated CareCorporation IndianaIndiana UniversityHealth Plans, Inc.MDwiseMarketplace, Inc.Physicians HealthPlan of NorthernIndiana, Inc.SoutheasternIndiana HealthOrganizationUpdated?New information obtained 4/27/15Plan issuer name updated 4/27/15
American Lung Association Report Appendix - State Health Insurance Marketplace Plans: New Opportunities for Helping Smokers QuitData collected January 15-February 11, 2015 unless otherwise noted. The American Lung Association will update this chart with new information as we are made aware of it. Please contact Jennifer.singleterry@lung.org if the information on a marketplace plan’s publically available formulary has been updated since February 11, 2015.Updated 8/24/15Chart KeyQL Quantity Limits; Listed in separate list linked to in the formulary; *Information found in document(s) separate from formulary; PA Prior authorization required; 0 Indicates 0 copay in formulary; ST step therapy; NA Not available; Not listed as smoking cessationListed on Formulary?StateMarketplace Type* Plan Issuer ederallyfacilitatedLALALAAnthemCaresourceKentucky PatchNicotineLozengeNicotineNicotineNasal Spray InhalerBupropion Varenicline Link to formulary that was usedUpdated?New information obtained 8/23/15.Preventive services document states:Tobacco cessation products includingselect generic prescription drugs,select brand-name drugs withno generic alternative, and FDAapproved over-the-counter products.New information obtained 6/1/15Yes0*Yes0 QLYes0*Yes0 QLYes0*Yes0 QLYes0*Yes QLYes0*Yes QLYes0*Yes0 QLYes0*Yes0 QLhttp://file.anthem.com/40627KYMENABS.pdf; 0/t0/pw e232596.pdf; http://file.anthem.com/13019ANMENABS.pdfNoYes0 NoNoYes0 NoNoYes0 NoYes QLYes0 YesYes QLYes0 NoYes QLYes0 Yes Yes QLYes0 Yes QLhttps://mykyhc.org/Documents/KYHC Formulary ENG.pdfHMO Louisiana, Inc. Yes0Yes0Yes0Yes0Yes0Yes0 ry2015Humana, Inc.Louisiana HealthCooperative, Inc.Yes0 Yes0 Yes0 Yes0 Yes0 Yes0 Yes0 e 2379728NoNoNoYes QLYes QLYes QLYes uideDrug-List?Yes0Yes0Yes0Yes0Yes0Yes0 ry2015Yes0 PAYes0 PAYes0 PAYes0 PA STYes0 PA ST Yes0 PAYes0 PA nsive/content/global assets/Exchanges/Essential%20PDL.pdfYes0 QLYes0 QLYes0 QLYes0 QLYes0 QLYes0 QLYes0 umentsYes0 QLYes0 QLYes0 QLNoYes0 QLYes0 QLYes0 ellness/formulary/New information obtained 4/28/15;new link posted ormation updated and corrected7/14/15NoYesNoYesNoYesYes QLNoYes QLYesYesYesYes stNoNoNoYes0 QLYes0 QLYes0 QLYes0 QLhttps://www.harvardpilgrim.org/pls/ext/f?p 768:27:3105790895515088::NO:RP:P27 s.humana.com/marketing/documents.asp?file 2379728New information obtained 7/29/15https://www.wellcarepdp.com/medication guide/defaultNew information obtained -runState-runMAState-runLouisiana HealthService & IndemnityCompanyUnitedHealthcareof Louisiana, Inc.Vantage HealthPlan, Inc.Ambetter fromCeltiCare HealthBlue Cross BlueShield ofMassachusettsBoston MedicalCenter HealthNetPlanFallon HealthHavard PilgrimHealth CareMAState-runHealth New England Yes0Yes0Yes0Yes0Yes0Yes QLYes Default.aspxMAState-runNoNoNoYesYesYes Yes QL PAhttps://www.minutemanhealthdirect.org/formulary 0NoYes0NoYes0Yes0Yes0Yes0YesYes0Yes c/portal/memberMainMAState-runMinuteman HealthNeighborhoodHealth PlanTufts Health PlanTufts Health Plan –Network HealthYes QLYes QLYes QLYes QLYes QLYes QLYes /pdl and rx/pdl direct en.pdfMAState-runYes0 PAYes0 PAYes0 PA STYes0 PA ST Yes0 PAYes0 PA obal assets/Exchanges/3%20Tier%20Advantage%20PDL.pdfNew information obtained 4/22/15MDState-runYes0 PAYes0 PAYes0 PA STYes0 PA ST Yes0 PAYes0 PA obal assets/Exchanges/4Tier%20Advantage%20PDL.pdfNew information obtained 4/27/15MDState-runUnited Healthcare Yes0 PAAll Savers InsuranceCo.Yes0 harmacy-info
State Marketplace Type* Plan Issuer Name Nicotine Gum Nicotine Patch Nicotine Lozenge Nicotine Nasal Spray Nicotine Inhaler Bupropion Varenicline Link to formulary that was used Updated?
