exclamation icon

Frequently asked questions for Hennepin Health SNBC plan members who joined April 1, 2025.

hennepin health your community health plan logo

Hennepin Health
  • Home
  • Members
  • Providers
  • About
    • Website
    • Provider updates

  • Find a provider/clinic
  • •
  • Forms/documents
  • •
  • Renewals
  • •
  • Get a ride
  • •
  • Services
  • •
  • Rewards
  • •
  • Wellness
  • •
  • Plans
  • •
  • Member News
  • •
  • •
  • Forms/formulary
  • •
  • Prior authorization
  • •
  • Claims/billing
  • •
  • Provider resources
  • •
  • Provider updates
  • •
  • Contract/registration
  • •
  • Provider Portal
  • •
  • Contact
  • •
  • About
  • •
  • Awards/recognition
  • •
  • Care coordination
  • •
  • Health care fraud/abuse
  • •
  • Quality management
  • •
  • Blog
  • •
  • Community outreach
  • •
  • Print
  • Download

Drug formulary changes for 2024 Q1

  • 12/29/2023

December 28, 2023

Subject

2024 Q1 drug formulary change notification.

Providers affected

All providers

Key points

  • Hennepin Health is making several changes to its drug formulary for Q1 2024. 
  • The changes apply to all Hennepin Health members.
  • The updated full drug formulary is available online. A printed copy can be obtained by calling Provider Services at 612-596-1036 (press 2).

Background

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 01/01/2024, these medications were removed:
Contrave
Nicotrol inhaler  
Nicotrol nasal spray 
Votrient tab

Effective 01/01/2024, these medications and UM requirements of prior authorization (PA)  were added:
Pazonpanib hcl tab

Effective 01/01/2024, this medication was added:
Methadone soln 5mg/5ml 

Effective 01/01/2024, these medications and UM requirements of quantity limits (QL) were added:
Paxlovid tab 150-100mg, QL = 20 tabs/fill
Paxlovid tab 300-100mg, QL = 30 tabs/fill
Lagevrio cap 200 mg, QL = 40 caps/fill

Effective 01/01/2024, the 90DS indicator was added to these medications:
Acarbose tab
Acetazolamide ER cap
Acetazolamide tab
Amantadine cap
Azathioprine tab
Benazepril/hydrochlorothiazide tab
Bisoprolol tap
Calcitriol cap
Carbamazepine chew tab
Carbidopa/Levodopa ER tab
Carbidopa/Levodopa tab
Dapsone tab
Diclofenac potassium tab
Diltiazem ER cap
Dorzolamide/Timolol Opth soln
Eplerenone tab 25 mg, 50 mg
Fenofibrate cap 67 mg, 134 mg, 200 mg 
Flecainide tab
Fluoxetine soln
Fluphenazine tab
Flurbiprofen tab
Fluvoxamine tab
Haloperidol tab
Hydroxychloroquine tab
Hyoscyamine sulfate CR tab
Indapamide tab
Isosorbide dinitrate tab
Labetalol tab
Lacosamide tab
Lactulose soln
Lamivudine soln
Leflunomide tab
Levetiracetam ER tab, Roweepra ER tab
Liothyronine tab
Losartan/hydrochlorothiazide tab
Lurasidone HCL tab 20 mg, 40mg, 60 mg
Mefloquine tab
Norethindrone tab
Oxcarbazepine tab
Phenytoin cap, Phenytoin ext cap
Phospha 250 neutral tab
Progesterone cap
Propranolol ER cap
Ranolazine tab
Sulindac tab
Timolol Maleate Ophth soln
Tolterodine tab
Topiramate tab
Torsemide tab
Trazodone tab
Valproic acid cap
Valsartan tab
Valsartan/hydrochlorothiazide tab
Ziprasidone cap 20 mg, 40 mg

Effective 01/01/2024, the 90DS indicator was removed from these medications:
Amlodipine/Valsartan tab
Cimetidine tab
Donepezil tab
Doxepin cap
Enalapril tab
Estradiol tab
Fludrocortisone tab
Gylburide/Metformin tab
Guanfacine IR tab
Levetiracetam tab, roweepra tab
Metolazone tab
Mirtazapine ODT
Nateglinide tab
Nifedipine ER tab
Nitroglycerin SL tab
Pentoxifylline ER tab
Potassium chloride ER cap
Potassium chloride ER tab 10 meq
Potassium chloride Micro tab
Prasugrel tab
Pravastatin tab
Prazosin cap
Primidone tab
Propranolol tab
Quetiapine XR tab
Sildenafil tab 20 mg
Sulfasalazine tab (AZULFIDINE equiv)
Tamoxifen tab
Verapamil ER tab

Resources

  • Hennepin Health Customer Service: 612-596-1036 (press 2)
  • Hennepin Health website 
  • 2024 Medicaid list of covered drugs (Formulary) – effective 1/1/2024 (PDF)

 

  • Contact
  • •
  • Careers
  • •
  • Nondiscrimination notice
  • •
  • Notice of privacy practices
  • •
  • Language and civil rights notices

Hennepin County logo © 2025 Hennepin County, Minnesota
Follow us