Discount Restrictions

This prescription savings benefit program covers thousands of medications. Only a few medications and strengths have discount restrictions. Here is a list of all medications with additional restrictions.

Age Restrictions refers to medications where our discounts are not available if you are 65 or older.

Benefit Restrictions refers to medications where our discounts are not available if you are covered by a federal or state funded benefit, such as Medicare, Medicaid, or Tricare.

• Advair HFA: 115-21mcg, 230-21mcg, 45-21 mcg
• Anoro Ellipta: 62.5-25mcg
• Arnuity Ellipta: 100 mcg, 200 mcg, 50 mcg
• Breo Ellipta: 100-25mcg, 200-25 mcg
• Flovent Diskus: 100 mcg, 250 mcg, 50 mcg
• Flovent HFA: 110 mcg, 220 mcg, 44 mcg
• Incruse Ellipta: 62.5 mcg
• Trelegy Ellipta: 100-62.5, 200-62.5

• Absorica: 10 mg, 20 mg, 25 mg, 30 mg, 35 mg, 40 mg
• Absorica LD: 16 mg, 24 mg, 32 mg, 8 mg
• Accu-chek Fastclix lancet drum
• Accu-chek guide test strip
• Accu-chek Softclix
• Adalat cc: 30 mg, 60 mg, 90 mg
• Addyi: 100 mg
• Adzenys ER: 1.25 mg/ml
• Adzenys XR-ODT: 12.5 mg, 15.7 mg, 18.8 mg, 3.1 mg, 6.3 mg, 9.4 mg
• Afrezza: 12 unit, 4 unit, 4 unit(30), 4 unit(60), 4 unit(90), 4-8-12(60), 8 unit, 8 unit(60), 8 unit(90)
• Afstyla: 1000 unit, 1500 unit, 2000 unit, 250 unit, 2500 unit, 3000 unit, 500 unit
• Airduo respiclick: 113-14 mcg, 232-14 mcg, 55-14 mcg
• Aklief: 0.00005
• Ala-quin: 3%-0.5%
• Ala-scalp: 0.02
• Alvesco: 160 mcg, 80 mcg
• Ampyra: 10mg
• Amzeeq: 0.04
• Anafranil: 25 mg, 50 mg, 75 mg
• Arakoda: 100 mg
• Auryxia: 210mg iron
• Avonex: 30 mcg, 30mcg/.5ml
• Avonex pen: 30mcg/.5ml
• Azasite: 0.01
• Balcoltra: 0.1-0.02mg
• Baqsimi: 3 mg
• Basaglar KwikPen U-100: 100/ml (3)
• Baxdela: 300 mg, 450 mg
• Belbuca: 150 mcg, 300 mcg, 450 mcg, 600 mcg, 75 mcg, 750 mcg, 900 mcg
• Bensal hp: 0.03
• Benzaclin: 1%-5%
• Betaine Anhydrous: 1g/scoop
• Bethkis: 300 mg/4ml
• Betimol: 0.0025, 0.005
• Beyaz: 3-0.02(24)
• Bidil: 20-37.5mg
• Binosto: 70 mg
• Bonjesta: 20mg-20mg
• Breztri Aerosphere: 160-9-4.8
• Brilinta: 60 mg, 90 mg
• Bromsite: 0.00075
• Bydureon BCise: 2mg/0.85ml
• Bydureon pen: 2mg/0.65ml
• Bynfezia: 2500mcg/ml
• Cambia: 50 mg
• Capex shampoo: 0.0001
• Carbaglu: 200 mg
• Carospir: 25 mg/5 ml
• Celebrex: 100 mg, 200 mg, 400 mg, 50 mg
• Cequa: 0.0009
• Cequr Simplicity: 2 unit
• Cequr Simplicity inserter
• Cerefolin NAC: 6-600-2 mg
• Citranatal 90 DHA: 90-1-300mg
• Citranatal Assure: 35-1-50 mg
• Citranatal B-calm: 20-1-25 mg
• Citranatal Bloom: 90-1-50 mg
• Citranatal DHA: 27-1-50 mg
• Citranatal Harmony: 27-1-50 mg
• Citranatal RX: 27-1-50 mg
• Climara: .025mg/24h, .0375mg/24, .075mg/24h, 0.05mg/24h, 0.06mg/24h, 0.1mg/24hr
• Climara Pro: 45-15/24H
• Clindesse: 0.02
• Clobex: 0.0005
• Colchicine: 0.6 mg
• Colcrys: 0.6 mg
• Combivent Respimat: 20-100 mcg
• Contrave: 8 mg-90 mg
• Cordran: 0.00025, 0.0005
• Cosopt PF: 2%-0.5%
• Cotempla XR-ODT: 17.3 mg, 25.9 mg, 8.6 mg
• Crestor: 10 mg, 20 mg, 40 mg, 5 mg
• Cystadane: 1g/scoop
• Deplin-Algal Oil: 15-90.314, 7.5-90.314
• Dermasorb HC: 0.02
• Dermasorb TA: 0.001
• Desowen: 0.0005
• Dexilant: 30 mg, 60 mg
• Differin: 0.001, 0.003
• Dilantin: 100 mg, 30 mg
• Dilantin-125: 125 mg/5ml
• Doptelet: 20 mg
• Doryx MPC: 120 mg
• Droplet Genteel lancing device
• Droplet insulin syringe: 29 g x1/2", 30 gx5/16", 30gx1/2", 30gx15/64", 31 gx5/16", 31gx15/64"
• Droplet lancets: 30 gauge
• Droplet Micron pen needle: 34 gx9/64"
• Droplet pen needle: 29 g x1/2", 30 gx5/16", 31 g x1/4", 31 gx3/16", 31 gx5/16", 32 gx 1/4", 32 gx3/16", 32 gx5/16", 32gx 5/32"
• Dropsafe pen needle: 31 g x1/4", 31 gx3/16"
• Dropsafe prep pads
• Duavee: 0.45-20 mg
• Dymista: 137-50 mcg
• Edarbi: 40 mg, 80 mg
• Edarbyclor: 40 mg-25mg, 40-12.5 mg
• Efudex: 0.05
• Emgality pen: 120 mg/ml
• Emgality syringe: 120 mg/ml, 300mg/3ml
• Endari: 5 g
• Enteragam: 5 g
• Epiduo: 0.1%-2.5%
• Epiduo Forte: 0.3%-2.5%
• Ertaczo: 0.02
• EstroGel: 1.25 g
• Eurax: 0.1
• Evamist: 1.53 mg/spray
• Evekeo ODT: 10 mg, 15 mg, 20 mg, 5 mg
• Eversense E3 sensor-HLDR
• Eversense E3 Smart transmitter
• Eysuvis: 0.0025
• Fabior: 0.001
• Farxiga: 10 mg, 5 mg
• Fensolvi: 45 mg
• Flarex: 0.001
• Flector: 0.013
• Flolipid: 20 mg/5 ml, 40mg/5ml
• Fluoxetine HCL: 60 mg
• Foltx: 2-1.13-25
• Forfivo XL: 450 mg
• Gel-one: 30 mg/3 ml
• Genotropin: 0.2mg/0.25, 0.4mg/0.25, 0.6mg/0.25, 0.8mg/0.25, 1.2mg/0.25, 1.4mg/0.25, 1.6mg/0.25, 1.8mg/0.25, 12 mg/ml, 1mg/0.25ml, 2mg/0.25ml, 5 mg/ml
• Gloperba: 0.6mg/5ml
• Glucagen: 1 mg
• Glucagon Emergency Kit: 1mg
• Glucocard Expression
• Glucocard vital sensor
• Glyxambi: 10 mg-5 mg, 25 mg-5 mg
• Gralise: 300 mg, 600 mg
• Grastek: 2800 unit
• Gynazole 1: 0.02
• Gynazole-1: 0.02
• Halog: 0.001
• Hemady: 20 mg
• Hizentra: 1 g/5 ml, 10 g/50 ml, 2 g/10 ml, 4 g/20 ml
• Horizant: 300 mg, 600 mg
• Humalog KwikPen U-200: 200/ml (3)
• Humatrope: 12 mg, 24 mg, 5 mg, 6 mg
• Humulin 70/30: 70-30/mL
• Humulin N: 100/mL
• Humulin R: 100/mL
• Hyalgan: 10 mg/ml
• Hymovis: 24 mg/3 ml
• Ilumya: 100 mg/ml
• Impoyz: 0.00025
• Inbrija: 42 mg
• Ingrezza: 40 mg, 60 mg, 80 mg
• Ingrezza initiation pack: 40 mg-80mg
• Insulin Glargine YFGN: 100/ml, 100/ml (3)
• Intrarosa: 6.5 mg
• Inveltys: 0.01
• Jardiance: 10 mg, 25 mg
• Jentadueto: 2.5 mg-1000 mg, 2.5 mg-500 mg, 2.5 mg-850 mg
• Jentadueto XR: 2.5 mg-1000 mg, 5 mg-1000 mg
• Jornay PM: 100 mg, 20 mg, 40 mg, 60 mg, 80 mg
• Kitabis Pak: 300 mg/5ml
• Klisyri: 0.01
• Kloxxado: 8 mg
• Kristalose: 10 g, 20 g
• Lenvima: 10 mg/day, 12 mg/day, 14 mg/day, 18 mg/day, 20 mg/day, 24 mg/day, 4 mg, 8 mg/day
• Levoxyl: 100 mcg, 112 mcg, 125 mcg, 137 mcg, 150 mcg, 175 mcg, 200 mcg, 25 mcg, 50 mcg, 75 mcg, 88 mcg
• Licart: 0.013
• Livalo: 1 mg, 2 mg, 4 mg
• Locoid: 0.001
• Loreev XR: 1 mg, 1.5 mg, 2 mg, 3 mg
• Luminopia
• Lyrica: 100 mg, 150 mg, 20 mg/ml, 200 mg, 225 mg, 300 mg, 50 mg, 75 mg
• Lyrica CR: 165 mg, 330 mg, 82.5 mg
• Lyumjev: 100ml
• Lyumjev KwikPen U-100: 100/mL
• Lyumjev KwikPen U-200: 200/mL (3)
• Macrobid: 100 mg
• Macrodantin: 100 mg, 25 mg, 50 mg
• Makena: 275 mg/1.1
• Metanx: 3-35-2 mg
• MetroCream: 0.0075
• MetroGel: 0.01
• MetroLotion: 0.0075
• Minocin: 50 mg
• Mirvaso: 0.0033
• Mitigare: 0.6 mg
• Mounjaro: 2.5 mg/0.5 ml, 5 mg/0.5 ml, 7.5 mg/0.5 ml, 10 mg/0.5 ml, 12.5 mg/0.5 ml, 15 mg/0.5 ml
• Mycapssa: 20 mg
• Myrbetriq: 25 mg, 50 mg, 8 mg/ml
• Naprelan: 750 mg
• Narcan: 4 mg/0.1 mL
• Natesto: 5.5/0.122
• Neevodha: 27-1.13 mg
• Nexium: 10 mg, 2.5 mg, 20 mg, 40 mg, 5 mg
• Niaspan: 1000 mg, 500 mg, 750 mg
• Nityr: 10 mg, 2 mg, 5 mg
• Nocdurna: 27.7 mcg, 55.3 mcg
• Norliqva: 1 mg/ml
• Nucala: 100 mg, 100 mg/ml, 40mg/0.4ml
• Odactra: 12 sq-hdm
• Omeclamox-pak: 20(20)-500
• Omnitrope: 10mg/1.5ml, 5 mg/1.5ml, 5.8 mg
• OneTouch Ultra test strip
• OneTouch Verio test strip
• Onzetra Xsail: 11 mg
• Oracea: 40 mg
• Oralair: 300 ir
• Orladeyo: 110 mg, 150 mg
• Osphena: 60 mg
• Otrexup: 10mg/0.4ml, 12.5mg/0.4, 15mg/0.4ml, 17.5mg/0.4, 20mg/0.4ml, 22.5mg/0.4, 25mg/0.4ml, 7.5 mg/0.4
• Oxtellar XR: 150 mg, 300 mg, 600 mg
• Pamelor: 10 mg, 25 mg, 50 mg, 75 mg
• Pancreaze: 10.5-35.5k, 16.8-56.8k, 2.6k-8.8k, 21 k-54.7k, 37k-97.3k, 4.2k-14.2k
• Pheburane: 483 mg/g
• Phoslyra: 667 mg/5ml
• Plegridy: 125mcg/0.5, 63-94 mcg
• Plegridy pen: 125mcg/0.5, 63-94 mcg
• Pogo automatic blood gluc sys
• Pogo automatic test cartridge: 30 gauge
• Pradaxa: 110 mg, 150 mg, 75 mg
• Praluent pen: 150 mg/ml, 75 mg/ml
• Premarin: 0.3 mg, 0.45mg, 0.625 mg, 0.625 mg/g, 0.9 mg, 1.25 mg
• Premphase: 0.625 (14)
• Prempro: 0.3-1.5mg, 0.45-1.5mg, 0.625-2.5, 0.625-5 mg
• Prenate chewable: 1 mg
• Prenate DHA: 18-1-300mg
• Prenate Elite: 20 mg-1 mg
• Prenate Enhance: 28-1-400mg
• Prenate Essential: 18-1-300mg
• Prenate Mini: 18-1-350mg
• Prenate Pixie: 10-1-200mg
• Prenate Restore: 27-1-400mg
• Primacare: 30-1-300mg
• Pristiq: 100 mg, 25 mg, 50 mg
• Proair RespiClick: 90 mcg
• Promiseb
• Promiseb Complete
• Protonix: 20 mg, 40 mg
• Qbrexza: 0.024
• Qnasl: 80 mcg
• Qnasl Children: 40 mcg
• Qsymia: 11.25-69mg, 15 mg-92mg, 3.75-23 mg, 7.5mg-46mg
• Qudexy XR: 100 mg, 150 mg, 200 mg, 25 mg, 50 mg
• Quillichew ER: 20 mg, 30 mg, 40 mg
• Quillivant XR: 5 mg/ml
• Qvar: 40 mcg, 80 mcg
• Qvar RediHaler: 40 mcg, 80 mcg
• Ragwitek: 12 unit
• Rasuvo: 10mg/0.2ml, 12.5/0.25, 15mg/0.3ml, 17.5/0.35, 20mg/0.4ml, 22.5/0.45, 25mg/0.5ml, 27.5/0.55, 30mg/0.6ml, 7.5mg/0.15
• Rayaldee: 30 mcg
• Reditrex: 10mg/0.4ml, 12.5mg/0.5, 15mg/0.6ml, 17.5mg/0.7, 20mg/0.8ml, 22.5mg/0.9, 25 mg/ml, 7.5mg/.3ml
• Relafen DS: 1000 mg
• Relpax: 20 mg, 40 mg
• reSET (SUD)
• reSET (SUD) (non-monetary CM)
• reSET-O (OUD)
• reSET-O (OUD)(non-monetary CM)
• Restoril: 15 mg, 22.5 mg, 30 mg, 7.5 mg
• Rhofade: 0.01
• Riomet: 500 mg/5ml
• Riomet ER: 500 mg/5ml
• Roxybond: 15 mg, 30 mg, 5 mg
• Ryaltris: 665-25 mcg
• Rybelsus: 14 mg, 3 mg, 7 mg
• Safyral: 3-0.03(21)
• Segluromet: 2.5-1000mg, 2.5-500 mg, 7.5-1000mg, 7.5-500 mg
• Sernivo: 0.0005
• Simbrinza: 1%-0.2%
• Sivextro: 200 mg
• Sklice: 0.005
• Slynd: 4 mg (28)
• Soolantra: 0.01
• Sorilux: 0.00005
• Spiriva Respimat: 1.25 mcg, 2.5 mcg
• Sprix: 15.75 mg
• Steglatro: 15 mg, 5 mg
• Steglujan: 15mg-100mg, 5 mg-100mg
• Stendra: 100 mg, 200 mg, 50 mg
• Stiolto Respimat: 2.5-2.5mcg
• Striverdi Respimat: 2.5 mcg
• Suprep: 17.5-3.13g
• Sutab: 1.479 g
• Symjepi: 0.15mg/0.3, 0.3mg/0.3
• Sympazan: 10 mg, 20 mg, 5 mg
• Symproic: 0.2 mg
• Synjardy: 12.5-1000, 12.5-500mg, 5 mg-500mg, 5mg-1000mg
• Synjardy XR: 10-1000 mg, 12.5-1000, 25-1000 mg, 5mg-1000mg
• Tadliq: 20 mg/5 ml
• Tazorac: 0.0005, 0.001
• Tecfidera: 120 mg, 120-240 mg, 240 mg
• Techlite pen needle: 29 g x1/2", 31 g x1/4", 31 gx3/16", 31 gx5/16", 32 gx 1/4", 32 gx5/16", 32gx 5/32"
• Tekturna: 150 mg, 300 mg
• Tekturna HCT: 150-12.5mg, 150mg-25mg, 300-12.5mg, 300mg-25mg
• Temixys: 300-300 mg
• Tenoretic 100: 100mg-25mg
• Tenoretic 50: 50 mg-25mg
• Tenormin: 100 mg, 25 mg, 50 mg
• Thiola: 100 mg
• Thiola EC: 100 mg, 00 mg
• Thyquidity: 100mcg/5ml
• Tiglutik: 50 mg/10ml
• Tirosint: 100 mcg, 112 mcg, 125 mcg, 13 mcg, 137 mcg, 150 mcg, 175 mcg, 200 mcg, 25 mcg, 50 mcg, 75 mcg, 88 mcg
• Tirosint-SOL: 100 mcg/ml, 112 mcg/ml, 125 mcg/ml, 13 mcg/ml, 137 mcg/ml, 150 mcg/ml, 175 mcg/ml, 200 mcg/ml, 25 mcg/ml, 37.5mcg/ml, 44 mcg/ml, 50 mcg/ml, 62.5mcg/ml, 75 mcg/ml, 88 mcg/ml
• Tlando: 112.5 mg
• Tobradex ST: 0.3%-0.05%
• Tofranil: 10 mg, 25 mg, 50 mg
• Topiramate ER: 100 mg, 150 mg, 200 mg, 25 mg, 50 mg
• Tosymra: 10 mg
• Toujeo Max Solostar: 300/ml (3)
• Toujeo Solostar: 300/ml
• Toviaz: 4 mg, 8 mg
• Tradjenta: 5 mg
• Treprostinil: 1 mg/ml, 10 mg/ml, 2.5 mg/ml, 5 mg/ml
• Tricor: 145 mg, 48 mg
• Trijardy XR: 10-5-1000, 12.5-2.5mg, 25-5-1000, 5-2.5-1000
• Trilipix: 135 mg, 45 mg
• Tri-luma: 0.01-.05-4
• Triluron: 10 mg/ml
• Trintellix: 10 mg, 20 mg, 5 mg
• Triptodur: 22.5 mg
• Trokendi XR: 100 mg, 200 mg, 25 mg, 50 mg
• True Metrix glucose test strip
• TruePlus pen needle: 29 g x1/2", 31 g x1/4", 31 gx3/16", 31 gx5/16", 32gx 5/32"
• Trulicity: 0.75mg/0.5, 1.5 mg/0.5, 3 mg/0.5ml, 4.5 mg/0.5
• Tudorza Pressair: 400 mcg
• Twirla: 120-30/24h
• Uloric: 40 mg, 80 mg
• Ultravate: 0.0005
• Ultravate X: 0.05%-10%
• Vascepa: 0.5 gram, 1 g
• Velphoro: 500mg iron
• Veltin: 1.2-0.025%
• Verkazia: 0.001
• V-go 20
• V-go 30
• V-go 40
• Viagra: 100 mg, 25 mg, 50 mg
• Visco-3: 10 mg/ml
• Vsl#3: 112.5b, 450b cell
• Vsl#3 DS: 900b cell
• Vtama: 0.01
• Vumerity: 231 mg
• Vyleesi: 1.75mg/0.3
• Winlevi: 0.01
• Wynzora: 0.005-.064
• Xhance: 93 mcg
• Xigduo XR: 10-1000 mg, 10mg-500mg, 2.5-1000mg, 5 mg-500mg, 5mg-1000mg
• Ximino: 135 mg, 45 mg, 90 mg
• Xofluza: 40 mg, 80 mg
• Xyosted: 100 mg/0.5, 50mg/0.5ml, 75mg/0.5ml
• Yasmin 28: 0.03mg-3mg
• Yaz: 0.02-3(28)
• Yonsa: 125 mg
• Zejula: 100 mg
• Zelnorm: 6 mg
• Zembrace symtouch: 3 mg/0.5ml
• Zerviate: 0.0024
• Zestoretic: 10-12.5 mg, 20 mg-25mg, 20-12.5 mg
• Zestril: 10 mg, 2.5 mg, 20 mg, 30 mg, 40 mg, 5 mg
• Zilxi: 0.015
• Zioptan: 0.000015
• Zoloft: 100 mg, 20 mg/ml, 25 mg, 50 mg
• Zolpimist: 5 mg/spray
• Zontivity: 2.08 mg
• Ztlido: 0.018
• Zyvox: 100 mg/5ml, 600 mg