Prilosec: No prescription means no coverage by benefit

Prilosec, the prescription antacid, will soon be available over-the-counter (OTC), but it will no longer be covered by DC 37’s Prescription Drug Benefit. As of Sept. 8, the well-known heartburn medication, in its most popular strength (20mg.), will be available without a prescription.

Higher doses of prescription-strength Prilosec will still be available for long-term treatment of conditions that need a doctor’s supervision, but they will not be covered by the DC 37 Health and Security Plan.

Consequently, when Prilosec OTC becomes available, neither Prilosec 20 mg., nor the higher doses of prescription strength Prilosec, nor its generic counterpart — omeprazole — will be covered by the DC 37 drug benefit.

The union benefit will continue to provide coverage for other proton pump inhibitors, such as: Nexium, Aciphex, Protonix and Prevacid. Plan coverage for them will continue at the current co-payment and subject to the 90-day restriction.

As with all medication, whether over-the-counter or prescription strength, you should speak with your physician before switching to an alternative treatment. If you have any questions, you can contact the NPA-Express Scripts Customer Service Call Center at 1-800-467-2006.