| Anthem Blue Cross (HMO, PPO, EPO) |
| Novarel (chorionic gonadotropin, human) |
| Hormones : Drugs for Women |
- Preventive Drug: Zero copay. Grand Fathered Plans at Tier 2
- Quantity Limit: 4 tablets per 1 day(s).
- Breast Cancer: HR+ (HER2+):
Duration: 1 year(s)
Documented Diagnosis: Yes
Medical Test Required: Yes
Reauthorization Required: No
Duration of Reauthorization: N/A
- Zero copay may apply. Zero copay may apply.
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