November 13, 2025
Effective December 1, 2025, the benefit limit for some medications will be changing from a 90-day supply maximum to a 30-day supply maximum. This change is effective for the Health Partners Plans Medicaid line of business.
The affected drugs are listed below. Please note these drugs may require Prior Authorization.
Medication Class |
Affected Medications |
New Limit |
Anticoagulants |
Eliquis, Xarelto, rivaroxaban |
Maximum 30-day supply per fill |
Bladder Relaxant Preparations |
Myrbetriq, mirabegron, Gemtesa |
|
Dry Eye Treatments |
Cequa, Restasis, cyclosporine, Xiidra |
|
GI Motility, Chronic Agents |
Amitiza, Linzess, lubiprostone, Motegrity, Movantik, prucalopride, Trulance, Viberzi, Ibsrela |
|
Hypoglycemics, Incretin Mimetics/Enhancers |
Janumet, Janumet XR, Januvia, Jentadueto, Jentadueto XR, Tradjenta |
|
Hypoglycemics, SGLT2 Inhibitors |
Farxiga, dapagliflozin glyburide/metformin hcl, Glyxambi, Invokamet, Invokamet XR, Invokana, Jardiance, Steglatro, Synjardy, Synjardy XR, glipizide/metformin hcl, Xigduo XR |
|
Neuropathic Pain Agents |
Gralise, Horizant, Savella |
For the latest formulary information, visit HPPlans.com/formularies. For questions, contact Health Partners Plans’ Pharmacy department at 215-991-4300 or Provider Services at 1-888-991-9023 (Mon–Fri, 9 am–4:30 pm).
Thank you for your cooperation in improving the quality of care you deliver to your patients and our members.