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Formulary Changes

Nebraska Total Care continually evaluates our Value-Add Formulary (PDF) to make sure our members receive clinically appropriate and cost conscious drug therapy.

Heritage Health - Nebraska Total Care 

Effective 10/01/2023:

The following vaccines have been added to the Nebraska Total Care Value Add formulary.  Please check the Value Add formulary document for any limitations of coverage.

  • Abrysvo
  • ACAM2000
  • Acthib
  • Arexvy
  • Biothrax
  • Dengvaxia
  • Engerix-B
  • Havrix
  • Heplisav-B
  • Hiberix
  • Imovax Rabies
  • Ipol
  • Ixiaro
  • Jynneos
  • Kinrix
  • M-M-R-II
  • Pediarix
  • Pedvax HIB
  • Pentacel
  • Prehevrbio
  • Priorix
  • Proquad
  • Quadracel
  • Rabavert
  • Recombivax HB
  • Rotarix
  • Rotateq
  • Stamaril
  • Typhim VI
  • Vaqta
  • Varivax
  • Vaxchora
  • Vaxelis
  • Vivotif
  • YF-Vax

 

Effective 08/08/2023:
Over-the-counter fish oil products will no longer be covered.  Prescription-only fish oil products will continue to be covered.

Effective 05/31/2023:
Brand name Tylenol products are no longer on the Nebraska Total Care Value-Add Formulary.

Effective 04/17/2023:
Dexcom G7 is preferred on the Nebraska Total Care Value- Add Formulary.