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Astagraf XL
Hawaii Medical Service Association (HMSA)
Hawaii Medical Service Association (HMSA) Coverage for Astagraf XL
All
8
Commercial
3
Health Exchange
2
Managed Medicaid
1
Medicare
2
Commercial
Commercial - PPO
No PA
No Step Therapy
No Quantity Limit
See Details
Commercial - HMO
No PA
No Step Therapy
No Quantity Limit
See Details
Commercial - Other Insurer
No PA
No Step Therapy
No Quantity Limit
See Details
Health Exchange
Health Exchange - PPO - Health Insurance Exchange
No PA
No Step Therapy
No Quantity Limit
See Details
Health Exchange - HDHP - Health Insurance Exchange
No PA
No Step Therapy
No Quantity Limit
See Details
Managed Medicaid
Managed Medicaid - HMO - Medicaid
No PA
No Step Therapy
No Quantity Limit
See Details
Medicare
Medicare - Medicare Advantage Part D
PA Required
No Step Therapy
No Quantity Limit
See Details
Medicare - Prescription Drug Plan
PA Required
No Step Therapy
No Quantity Limit
See Details
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