Frequently asked questions for Hennepin Health SNBC plan members who joined April 1, 2025.
We have made several changes to the drug formulary. These changes apply to Hennepin Health-PMAP, Hennepin Health-MinnesotaCare and Hennepin Health-SNBC members. Members who are directly impacted will receive notification of the changes. The updated full drug formulary is available on the website. A printed copy can be obtained by calling Provider Services at 612-596-1036 (press 2).
Effective 10/15/2023, these medications were added: COVID-19 Vaccine INJ 6M-11Y (MODERNA) COVID-19 Vaccine INJ 5-11Y (PFIZER) COVID-19 Vaccine 6M-4Y (PFIZER) COMIRNATY INJ SPIKEVAX INJ Effective 11/01/2023, these UM requirements of prior authorizations (PA) and/or quantity limits (QL) were added:
Metronidazole gel 1%; QL = 60 gm/30days Metronidazole gel 0.75%; QL = 45gm/30 days Glipizide/metformin tab; PA
Effective 11/01/2023, these UM requirements of prior authorizations (PA) and/or quantity limits (QL) were removed: Janumet tab; removed QL Glyburide/metformin tab; remove PA required for members age 65 or older and replace with PA required for all ages Jentadueto tab; remove PA required for members age 65 or older and replace with PA required for all ages Kombiglyze XR tab; remove PA required for members age 65 or older and replace with PA required for all ages Saxagliptin/metformin er tab; remove PA required for members age 65 or older and replace with PA required for all ages Effective 12/01/2023, these medications were removed: Cimetidine soln 300 mg/5ml CIMITIDINE SOLN 300 mg/5ml Effective 12/01/2023, these UM requirements of prior authorizations (PA) and/or quantity limits (QL) were added: Famotidine susp; PA for 9 years and older; QL = 50ml/30 days RESOURCES