exclamation icon

Learn more about new federal Medicaid changes.

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
  • •
  • Contracting
  • •
  • Provider Portal
  • •
  • Credentialing
  • •
  • Contact
  • •
  • About
  • •
  • Awards/recognition
  • •
  • Care coordination
  • •
  • Health care fraud/abuse
  • •
  • Quality management
  • •
  • Blog
  • •
  • Community outreach
  • •
  • Print
  • Download

2026 Q1 Drug Formulary Change Notification

  • 12/04/2025

Hennepin Health is making a change to its drug formulary for Q1 2026. This change applies to Hennepin Health-PMAP, Hennepin Health-MNCare 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 Hennepin Health website. A printed copy can be obtained by calling Provider Services at 612-596-1036 (select option 2). 

Effective Jan. 1, 2026, these medications will be added as preferred drugs to the formulary:

  • Freestyle Libre 2 Plus Sensor Kit
  • Testosterone gel (AG) (Vogelxo)
  • Testosterone gel packet (AG) (Vogelxo)
  • Proglycem suspension
  • Zegalogue syringe
  • Zegalogue autoinjector
  • Zomacton vial
  • Erythromycin base tablet
  • Erythromycin base tablet DR
  • Diclofenac gel OTC
  • Etodolac (oral)
  • Indomethacin capsule ER
  • Piroxicam
  • Azelastine (ophthalmic)
  • Tretinoin cream
  • Tretinoin gel (Avita, Retin-A)
  • Adapalene gel OTC

Effective Jan. 1, 2026, these medications will be removed as preferred drugs on the formulary and will require a prior authorization:

  • Genotropin cartridge
  • Genotropin syringe
  • Invokana
  • Zafirlukast
  • Erythromycin base capsule DR
  • Ketoprofen
  • Retin-A cream
  • Retin-A gel

Effective Jan. 1, 2026, these medications will have prior authorization requirements:

  • Testosterone gel (AG) (Vogelxo)
  • Testosterone gel packet (AG) (Vogelxo)
  • Androgel gel pump
  • Amitiza
  • Relistor (oral)
  • Relistor syringe
  • Relistor vial
  • Glucagon (injection)
  • Diazoxide suspension
  • Glucagon emergency kit (Lupin)
  • Fluticasone furoate (Arnuity Ellipta) (AG)
  • Genotropin cartridge
  • Genotropin syringe
  • Nutropin AQ pen
  • Zomacton vial
  • Insulin glargine vial (Winthrop)
  • Insulin glargine Solostar pen
  • Merilog vial
  • Merilog Solostar pen
  • Invokana
  • Actoplus Met
  • Myhibbin suspension
  • Nasonex
  • Olopatadine (nasal)
  • Veramyst
  • Zetonna
  • Zafirlukast
  • Erythromycin base capsule DR
  • E.E.S. 400 tablet
  • Diclofenac gel
  • Ketoprofen
  • Diclofenac potassium tablet
  • Diclofenac potassium capsule
  • Diclofenac sodium pump
  • Diclofenac solution
  • Diflunisal (oral)
  • Etodolac tab SR
  • Ibuprofen 300 mg tablet
  • Indomethacin oral suspension
  • Indomethacin (rectal)
  • Lofena
  • Mobic tablet
  • Naproxen suspension
  • Tolmetin sodium capsule
  • Tolmetin sodium tablet
  • Zipsor
  • Zorvolex
  • Alomide
  • Loteprednol (ophthalmic)
  • Bromfenac (Prolensa)
  • Dexycu (intraocular)
  • Prednisolone sod phosphate (ophthalmic)
  • Tryptyr (ophthalmic)
  • Pilocarpine (ophthalmic)
  • Pilocarpine (Vuity) (ophthalmic)
  • Trusopt
  • Vuity
  • Retin-A cream
  • Retin-A gel
  • Tretinoin gel (Atralin)
  • Differin gel 1% OTC

Effective Jan. 1, 2026, prior authorizations will be removed from these medications:

  • Freestyle Libre 2 Plus Sensor Kit
  • Proglycem suspension
  • Zegalogue syringe
  • Zegalogue autoinjector
  • Erythromycin base tablet
  • Erythromycin base tablet DR
  • Indomethacin capsule ER
  • Piroxicam
  • Azelastine (ophthalmic)
  • Tretinoin cream
  • Tretinoin gel (Avita, Retin-A)

Effective Jan. 1, 2026, these medications will have quantity limits (QL):

  • Freestyle Libre 2 Plus Sensor Kit
  • Glucagon (injection)
  • Proglycem suspension
  • Zegalogue syringe
  • Zegalogue autoinjector
  • Glucagon emergency kit (Lupin)
  • Erythromycin base tablet
  • Erythromycin base tablet DR
  • Diclofenac gel
  • Diclofenac gel OTC
  • Indomethacin capsule ER
  • Piroxicam
  • Azelastine (ophthalmic)
  • Retin-A cream
  • Retin-A gel
  • Tretinoin cream
  • Tretinoin gel (Avita, Retin-A)
  • Adapalene gel OTC
  • Arnuity Ellipta
  • Tretinoin gel (Atralin)
  • Differin gel 1% OTC

Effective Jan. 1, 2026, the 90DS indicator will be removed from these medications: 

  • mefloquine tab
  • jinteli tab
  • levocarnitine tab
  • propranolol tab
  • cholestyramine powder pack
  • hyoscyamine sulfate CR tab
  • ursodiol tab
  • trazodone tab
  • fluoxetine tab
  • fluoxetine soln
  • desipramine tab
  • risperidone soln
  • haloperidol tab
  • chlorpromazine tab
  • diclofenac sodium EC tab
  • carbamazepine ER tab
  • lacosamide tab
  • levetiracetam ER tab, roweepra ER tab
  • carbidopa/levodopa tab
  • cyclosporine modified cap, gengraf cap

 

Effective Jan. 1, 2026, the 90DS indicator will be added to these medications: 

  • abacavir tab
  • exemestane tab
  • repaglinide tab
  • clonidine patch
  • enalapril/hydrochlorothiazide tab
  • cholestyramine lite powder
  • cholestyramine lite powder pack
  • colestipol tab
  • omega-3 acid ethyl esters cap
  • calcium acetate cap
  • citalopram soln
  • sertraline conc
  • fluphenazine tab
  • trifluoperazine tab
  • aripiprazole soln
  • thiothixene cap
  • naproxen sodium tab
  • lamotrigine ER tab
  • dorzolamide/timolol ophth soln
  • tacrolimus cap
  • azathioprine tab

 

Resources

  • Hennepin Health Customer Services: 612-596-1036 (press 2) 
  • List of Covered Drugs (Formulary) effective 01/01/2026 (PDF)
  • Hennepin Health website: www.hennepinhealth.org
 
  • Contact
  • •
  • Careers
  • •
  • Nondiscrimination notice
  • •
  • Notice of privacy practices
  • •
  • Language and civil rights notices

Hennepin County logo © 2025 Hennepin County, Minnesota
Follow us