Over-the-counter Drug Coverage

Tufts Health Plan pharmacy benefits cover the over-the-counter (OTC) drugs and products listed below for members with a prescription, and when dispensed as a prescription at a pharmacy.

Generic vs. brand names

Generic drugs have the same active ingredients and work the same as brand-name drugs. We cover brand-name drugs only when a generic drug is not available.

Copayments for generic drugs

Copayments for generic drugs are $0 for up to a 30-day supply. For additional information, see pharmacy copayments.

OTC drugs

Acne products

Generic name (What your doctor should prescribe)	Example of brand name
Benzoyl peroxide 5% and 10%	Benzac W 5

Allergy/antihistamines

Generic name (What your doctor should prescribe)	Example of brand name
Cetirizine	Zyrtec OTC
Cetirizine/pseudoephedrine	Zyrtec-D OTC
Chlorpheniramine	Chlor-trimeton
Diphenhydramine	Benadryl
Fluticasone	Flonase
Loratadine	Alavert, Claritin
Loratadine/pseudoephedrine	Alavert-D, Claritin-D
Triamcinolone nasal spray	Nasacort Allergy

Analgesic/pain drugs

Generic name (What your doctor should prescribe)	Example of brand name
Acetaminophen (quantity limit 4 gm/day)	Tylenol
Aspirin	Bayer
Ibuprofen	Advil
Naproxen	Aleve

Antacids, antigas and antinausea

Generic name (What your doctor should prescribe)	Example of brand name
Aluminum hydroxide	Alternagel
Aluminum hydroxide/magnesium hydroxide	Maalox
Aluminum hydroxide/magnesium hydroxide/simethicone	Mylanta
Magaldrate, magaldrate/simethicone	Riopan
Meclizine	Dramamine
Simethicone	Mylicon

Antidandruff

Generic name (What your doctor should prescribe)	Example of brand name
Selenium sulfide topical	Selsun Blue

Antidiarrheals

Generic name (What your doctor should prescribe)	Example of brand name
Acidophilus, lactobacillus (age 18 and under)	Culturelle, Probiotic, Acidophilus
Bismuth subsalicylate, attapulgite	Pepto-Bismol, Kaopectate
Loperamide	Imodium AD

Antifungal drugs

Generic name (What your doctor should prescribe)	Example of brand name
Clotrimazole 1% topical	Lotrimin
Clotrimazole 1% vaginal	Gyne-Lotrimin
Miconazole topical	Monistat-Derm
Miconazole vaginal	Monistat
Tolnaftate	Tinactin

Antiulcer drugs/heartburn

Generic name (What your doctor should prescribe)	Example of brand name
Cimetidine	Tagamet
Esomeprazole (requires prior authorization)	Nexium OTC
Famotidine	Pepcid AC
Rantidine	Zantac

Contraceptive agents ($0 copayment)

Generic name (What your doctor should prescribe)	Example of brand name
Levonorgestrel	Plan B
Nonoxynol-9	Conceptrol, Emko

Cough/cold products

Generic name (What your doctor should prescribe)	Example of brand name
Brompheniramine/phenylephrine	Dimetapp
Guaifenesin	Robitussin
Guaifenesin DM	Robitussin DM
Pseudoephedrine	Sudafed

Counterirritants

Generic name (What your doctor should prescribe)	Example of brand name
Capsaicin	Zostrix

Diabetes drugs

Generic name (What your doctor should prescribe)	Example of brand name
Glucose tablets and gel	Glucose

Dry-skin preparations

Generic name (What your doctor should prescribe)	Example of brand name
Ammonium lactate topical	Amlactin
White petrolatum	Hydrolatum

Ear drops

Generic name (What your doctor should prescribe)	Example of brand name
Carbamide peroxide	Debrox

Electrolyte solution

Generic name (What your doctor should prescribe)	Example of brand name
Electrolyte solution	Pedialyte

First aid/antiseptics/disinfectants

Generic name (What your doctor should prescribe)	Example of brand name
Bacitracin topical	Bacitracin topical
Bacitracin/polymyxin B	Double antibiotic
Chlorhexidine gluconate	Hibiclens
Hydrogen peroxide	Hydrogen peroxide
Iodine	Iodine
Isopropyl alcohol	Isopropyl alcohol
Povidone	Betadine
Triple antibiotic ointment, neomycin/bacitracin/polymyxin B	Neosporin

Laxative/stool softeners

Generic name (What your doctor should prescribe)	Example of brand name
Bisacodyl	Dulcolax
Cascara	Nature’s Remedy
Docusate sodium, docusate calcium	Colace, Surfak
Docusate sodium with casanthranol	Docusate sodium with casanthranol
Glycerin suppositories	Glycerin suppositories
Magnesium citrate	Citrate of Magnesia
Magnesium hydroxide	Milk of Magnesia
Methylcellulose	Citrucel
Mineral oil	Mineral oil
Psyllium	Metamucil
Senna	Senokot
Sennosides/docusate sodium	Doc-Q-Lax
Sodium phosphate	Fleet Enema

Lice treatments

Generic name (What your doctor should prescribe)	Example of brand name
Permethrin	NIX
Piperonyl butoxide/pyrethin	RID
Piperonyl butoxide/pyrethin/permethrin	RID Kit

Nasal sprays

Generic name (What your doctor should prescribe)	Example of brand name
Cromolyn	Nasalcrom
Oxymetazoline nasal spray	Afrin
Sodium chloride nasal spray	Ocean

Overactive bladder

Generic name (What your doctor should prescribe)	Example of brand name
Oxybutynin transdermal patch	Oxytrol

Ophthalmic/eye drugs

Generic name (What your doctor should prescribe)	Example of brand name
Ocular lubricant	Artificial Tears
Ketotifen fumarate	Alaway, Zaditor
Naphazoline	Naphcon
Naphazoline/pheniramine	Naphcon-A, Opcon-A, Visine-A
Sodium chloride 5% drops	Muro-128 drops
Tetrahydrozoline	Visine

Poison ivy/rash treatments

Generic name (What your doctor should prescribe)	Example of brand name
Calamine lotion	Calamine lotion
Colloidal oatmeal	Aveeno Oatmeal Bath
Hydrocortisone topical	Anusol-HC
Zinc oxide topical	Balmex

Sleep aids

Generic name (What your doctor should prescribe)	Example of brand name
Melatonin 1 mg, 3 mg, 5 mg	Melatonin

Smoking deterrents

Generic name (What your doctor should prescribe)	Example of brand name
Nicotine gum	Nicorette, Nicorette DS
Nicotine lozenges	Commit
Nicotine patch	Nicoderm

Vitamins/minerals/supplements

Generic name (What your doctor should prescribe)	Example of brand name
Calcium carbonate	Oscal
Calcium carbonate with vitamin D	Oscal + D
Calcium citrate	Citracal
Calcium citrate with vitamin D	Citracal + D
Calcium with vitamin D	Calcium with vitamin D
Co-enzyme Q10 (age 18 and under)	Co-enzyme Q10
Ferrous fumarate	Femiron
Ferrous gluconate	Fergon
Ferrous sulfate	Feosol
Fish oil	Fish oil
Folic acid	Folvite
Magnesium gluconate	Magonate
Magnesium oxide	Uro-Mag
Multivitamins	Multivitamins
Multivitamins with minerals	Multivitamins with minerals
Niacin	Niacin
Niacinamide	Niacinamide
Nicotinic acid	Niaspan ER
Omega-3 fish oil	Omega-3 fish oil
Potassium phosphate	Neutra-Phos, Neutra-Phos K
Prenatal vitamins (without DHA)	Prenatal vitamins (without DHA)
Vitamin A	Vitamin A
Vitamin B	Vitamin B
Vitamin B-12	Vitamin B-12
Vitamin C	Vitamin C
Vitamin D	Vitamin D
Vitamin E	Vitamin E