Frequently Asked Questions
Q: What is a formulary or Preferred Medication List (PML)?
A: A formulary or also referred to as a Preferred Medication List (PML) is a list of safe and cost effective drugs, chosen
by a committee of physicians and pharmacists. Formularies have been used in hospitals for many years to help ensure
quality drug use. The WHI formulary is continually reviewed and revised to reflect the changing drug market.
Q: Are generic drugs as effective as brand drugs?
A: Yes. Generic drugs may only become available after a brand name product has been on the market for several years
and loses patent protection. After that time, several manufacturers can produce the product so the price drops
significantly. The generic medication has the same quality, safety and strength as its brand counterpart. FDA approved
generic drugs must have:
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Same amount of active ingredient(s)
Same dosage form
Taken the same way
Enters the bloodstream to the same extent as the brand
Q: Are all drugs within a class equally effective at treating my condition?
A: They can be. Your doctor or pharmacist will know whether other drugs within a class are equally effective for treating
your condition. Information on other drugs in the same class may also be found on our website at www.mywhi.com
under “Member Services” or you can call the WHI Customer Care Center at 1-877-380-8078 to discuss alternatives.
Q: If a prescribed drug has a retail cost that is less than the applicable copay, will the pharmacy charge me the
retail cost or the copay?
A: If the retail cost of your medication is less than the copay, you will be charged the lower cost.
Q: How can I get a list of the formulary or the Preferred Medication List (PML) of drugs?
A: A copy of WHI's complete list of formulary drugs can be found on our website at www.mywhi.com. Please note that
although a drug is on the formulary, it does not necessarily mean that it is a covered drug under your plan. Please refer
to your Summary Plan Description for a list of coverages/exclusions. If you have questions or need more information,
please:
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Ask your physician to discuss the list with you.
Call the WHI Customer Care Center number on the back of your ID card to speak with a representative.
Q: How does Walgreens Health Initiatives determine if a drug is Preferred?
A: A drug becomes Preferred if the Pharmacy & Therapeutics (P&T) Committee consisting of physicians and
pharmacists recommends a drug for inclusion. The committee reviews medications to determine their effectiveness,
safety and overall value, based on their own merits and in comparison to therapeutic alternatives. Newer medications
are constantly being evaluated with additions to PML done on a quarterly basis. Deletes to the PML are performed on
an annual basis at the beginning of each year. For the most current edition of the WHI formulary, please go to our website at www.mywhi.com.
Q: What should I say to my doctor when I talk to him about my drug plan?
A: You should inform your physician that you have a three tier pharmacy benefit copay, and show him/her the listing
mailed to you November 2009 with your ID card. Ask the question, “Are there drugs in the 1st (generic), 2nd (preferred
brand), or a less expensive drug in the 3rd (non-preferred brand) tier that is appropriate for my medical condition?”
Q: If the drug is only available as a brand drug, what is my copay?
A: If the drug is only available as a brand drug and no generic equivalent is available, your copay would be either the
amount of your second tier copay if a Preferred Brand drug is selected or the amount of third tier copay if a NonPreferred drug is selected.
Getting your prescriptions filled
Q: How do I get my prescription refills at the retail pharmacy starting December 14, 2009?
A: If you have valid prescription refills available, they will automatically be transferred from your previous pharmacy
benefit manager to our network of participating retail pharmacies. To get your prescription refilled, just visit a
participating retail pharmacy. Present your Walgreens Health Initiatives member ID card and ask the pharmacist to
process your refill.
Q: Can I obtain a 90 day supply of medication at the retail pharmacy?
A: Yes, choice and convenience that’s what you get with Walgreens90, a new benefit that is available to you starting
December 14, 2009 for your maintenance medications. Walgreens90 offers you the flexibility of filling your 90-day
prescriptions for maintenance medication at either a Walgreens retail pharmacy or through Walgreens Mail Service for
the same copay.
Walgreens Mail Service
Q: Will my refills be transferred from my previous pharmacy benefit manager mail facility?
A: Yes, if you have valid prescription refills available, they may automatically be transferred from your previous
pharmacy benefit manager to Walgreens Mail Service. To find out if your refills have been transferred, please call
1-877-380-8078. Walgreens Mail Service offers you a convenient way to receive your maintenance medications—
delivered by mail right to your door. Through this program, you can request a 90-day supply of your maintenance
medications.
Q: Will I need to register with Walgreens Mail Service?
A: Yes, you will need to register with Walgreens Mail Service to begin using the mail service pharmacy. Walgreens Mail
Service will fill your prescriptions at our Tempe, Arizona location. You can register and establish an online account with
the mail order program by visiting mywhi.com and selecting Go to Mail Service. Under Mail Service Registration and
Order Forms, choose the register online option. Complete the information on the next screen, and continue following
the prompts to finish your registration.
Q: Can I register for Walgreens Mail Service by fax or mail?
A: Yes, you can register and place your first order with Walgreens Mail Service by mail or fax. To register and place
your first order by mail, complete the Registration & Prescription Order Form that was included, along with your
Walgreens Health Initiatives Benefit Packet. Send the completed form, along with an original prescription (written for a
90-day supply) from your doctor, and payment, to the address on the form. If you need to start taking your medication
right away, ask your doctor for two prescriptions: one for a two-week supply to fill at your local Walgreens pharmacy,
and one for a 90-day supply to fill through the mail or by fax.
Q: Can I access my family’s prescriptions through my online account?
A: No. Our system identifies registered members by a unique prescription profile, and stores the member’s
prescription medication history in their own account. For this reason, please register family members separately, and
assign everyone their own user name. Email addresses and passwords may be the same. Once each family member
is registered, they can order their own refills and prescriptions, or you can do it for them.
Q: Can I view my retail prescription history online?
A: Yes, you can access a list of prescription you filled at pharmacies in the Walgreens network during the past 18
months. In order to protect your privacy, we require that you verify access to your online account by entering a recent
prescription number. You will only have to do this once to unlock your order history online.
Q: If I had a previous Prior Authorization for a specific medication with my previous plan, will the prior
authorization still be valid?
A: Yes, your valid prior authorizations will be loaded in the Walgreens system
Q: How can I get additional information?
A: If you need additional assistance with your pharmacy benefit, please call the Walgreens Customer Care Center @ 1877-380-8078.
WHI’s Formulary – Common Medications
Effective December 14, 2009, your prescription drug benefits will be administered by Walgreens Health Initiatives (WHI).
There are some differences between the WHI formulary and the Express Scripts formulary that we would like to bring to
your attention.
The following chart lists some of the more common medications and their tier status on the WHI formulary.
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1st tier: includes less-costly generic medications (listed below in lower-case letters). These medications generally
have the lowest copayment.
2nd tier: includes PREFERRED BRANDS on the PML (listed below in all UPPER-CASE LETTERS). These
medications usually have a mid-level copayment.
3rd tier: includes non-preferred brands (not listed on the PML). When a generic version of a brand-name medication
becomes available, most brand-name drugs move to the highest copayment tier. These medications are rarely
listed on the PML since they do not minimize costs as effectively as other medications listed.
Express Scripts Preferred Medications / WHI Non-Preferred Brands: some of the medications that were
preferred brands under Express Scripts are non-preferred brands under the WHI PML.
If you are interested in switching to a medication that is on WHI’s formulary, please talk to your doctor. There may be a
generic or preferred-brand alternative that is appropriate for you. You should not discontinue any prescription without your
doctor’s approval. The WHI PML may be searched or downloaded from WHI’s web site at www.mywhi.com, under “Member
Services.” For more information on the WHI formulary, please contact WHI’s Customer Care Center at 1-877-380-8078.
Medical Condition/ Medication
Category
WHI Generic (1st
Tier)
WHI Preferred Brand
(2nd Tier)
WHI Non-Preferred Brand
(3rd Tier)
ESI Preferred Brands/
WHI Non-Preferred
Brands
Acid Reflux Disease
(Gastrointestinal)
famotidine,
nizatidine, ranitidine,
omeprazole,
pantoprazole
fexofenadine,
fluticasone,
flunisolide
PREVACID, NEXIUM
ACIPHEX, KAPIDEX
None
ASTELIN, ASTEPRO,
NASONEX
ALLEGRA-D, BECONASE AQ,
CLARINEX, NASACORT AQ,
RHINOCORT AQUA,
VERAMYST, XYZAL
ALLEGRA-D, NASACORT
AQ, VERAMYST, XYZAL
Asthma
albuterol, cromolyn
sodium, ipratropium
solution,
metaproterenol,
theophylline
ALUPENT,
ATROVENT,
AZMACORT,
COMBIVENT,
FORADIL,
SEREVENT, SPIRIVA,
UNIPHYL, ADVAIR,
SYMBICORT,
ASMANEX,
FLOVENT, INTAL,
PERFOROMIST,
PROAIR HFA,
PROVENTIL HFA,
PULMICORT, QVAR,
SINGULAIR,
VENTOLIN HFA,
XOPENEX SOLUTION
ACCOLATE, AEROBID,
AEROBID-M, MAXAIR,
XOLAIR, XOPENEX HFA
XOPENEX HFA
Blood Pressure (ACE and ARB
classes)
benazepril, captopril,
enalapril, fosinopril,
lisinopril, moexipril,
quinapril, ramipril,
trandolapril
COZAAR, DIOVAN,
DIOVAN/HCT,
HYZAAR
AVAPRO, AVALIDE,
BENICAR, BENICAR HCT,
TARKA, MICARDIS,
MICARDIS HCT, TEVETEN,
TEVETEN HCT
None
Contraceptives
All generic oral
contraceptives are
1st tier. For
example: apri,
camila, levora, lowogestrel,
microgestin, necon,
nortrel, notrel 7/7/7,
velivet, zovia
YAZ
LOESTRIN FE, LYBREL,
ORTHO TRI-CYCLEN LO,
ORTHO EVRA, OVCON-50,
SEASONALE, YASMIN
ORTHO TRI-CYCLEN LO,
YASMIN
Depression
buproprion ext-rel,
citalopram,
fluoxetine,
mirtazapine,
paroxetine,
paroxetine CR,
sertraline
lovastatin,
pravastatin,
simvastatin
EFFEXOR XR,
LEXAPRO,
CYMBALTA, PRISTIQ,
VENLAFAXINE HCL
None
None
CRESTOR, LIPITOR
LESCOL, LESCOL XL,
VYTORIN
None
Allergies – Nasal Inhalers and
Non-Sedating Antihistamines
High Cholesterol (Statins)
Other notable medications
PROVIGIL NARCOLEPSY
LEVITRA - ERECTILE
DYSFUNCTION