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Pharmacy Information

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Formulary

AultCare Prescription Information Website RxEOB (Click Here)
If your employer's plan participates in the RxEOB program, use this link to access your prescription claim history and copay information online. You may need to establish a separate login account.

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.

Specialty Pharmacy
     BioScrip
     Mail Order Form
     Patient Brochure


Aultra Pharmacy

Pharmacy News:

Migraine Limitations
  Not all plans are subject to migraine limitations.

Brand name medications that now have generic equivalents available.

*All strengths & dosage forms may not be available*

Allegra Amaryl Ambien Biaxin XL Celexa
Cipro XR Coreg Ditropan XL Duragesic Elocon
Famvir Flonase Floxin Otic Inderal LA Loprox
Mavik Mevacor Mobic Naprosyn Norvasc
Omnicef Paxil Penlac 8% Solution Pravachol Prilosec
Proscar Toprol XL Wellbutrin XL Zithromax Zocor
Zofran Zoloft


Medications that require Prior Authorization
• Growth Hormones
• Injectable Infertility medications
• Magnacet
• Opana and Opana ER
• Oracea
• Solodyn
• Xolair and Synagis - if approved; this medication is covered under medical benefit not prescription benefit.

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.


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