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.
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.