Anthem Blue Cross (HMO, PPO, EPO)
Elestrin (estradiol)
Hormones : Drugs for Women
  • Quantity Limit: 1 pump per 30 day(s).
  • Step Therapy: Vasomotor Symptoms Associated with Menopause (VMS):
    ST Multiple Generics

  • Vasomotor Symptoms Associated with Menopause (VMS):
    Duration: 1 year(s)
    Documented Diagnosis: No
    Medical Test Required: No
    Reauthorization Required: No
    Duration of Reauthorization: N/A

  • Prior Authorization: Vasomotor Symptoms Associated with Menopause (VMS):
    Duration: 1 year(s)

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