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Elizabeth M. Whitehorn, Director

Provider Notice issued 01/09/12

90 Day Supply

​To: ​Participating Pharmacies
​Date: ​January 9, 2012
​Re: ​90 Day Supply

Effective December 1, 2011, and pursuant to Public Act 097-0074, the department implemented a 90 day supply reimbursement policy for certain generic, non-narcotic, oral, maintenance medications. These disease states currently include hypertension, diabetes, and hypothyroidism. This policy is being implemented as a cost saving measure by the department. This policy may be expanded in the future to include additional disease states.

A listing of the medications is included with this notice.

Any questions regarding this notice should be directed to the Bureau of Pharmacy Services at 1-877-782-5565, option 7.

Theresa A. Eagleson, Administrator

Division of Medical Programs

Medications subject to the 90 Day Supply Policy

Generic Name

  • Acebutolol HCL

  • Amiloride HCL

  • Amiloride/Hydrochlorothiazide

  • Amlodipine Besylate

  • Atenolol

  • Atenolol/Chlorthalidone

  • Benazepril HCL

  • Betaxolol HCL

  • Bisoprolol Fumarate

  • Bisoprolol Fumarate/HCTZ

  • Bumetanide

  • Captopril

  • Carvedilol

  • Chlorothiazide

  • Chlorpropamide

  • Clonidine HCL

  • Digoxin

  • Diltiazem HCL

  • Doxazosin Mesylate

  • Enalapril Maleate

  • Eplerenone

  • Felodipine

  • Folic Acid

  • Fosinopril Sodium

  • Furosemide

  • Glimepiride

  • Glipizide

  • Glipizide/Metformin HCL

  • Glyburide

  • Glyburide,Micronized

  • Glyburide/Metformin HCL

  • Guanabenz Acetate

  • Guanfacine HCL

  • Hydralazine HCL

  • Hydrochlorothiazide

  • Indapamide

  • Labetalol HCL

  • Levothyroxine Sodium

  • Liothyronine Sodium

  • Lisinopril

  • Losartan Potassium

  • Metformin HCL

  • Methyldopa

  • Methyldopa/Hydrochlorothiazide

  • Metolazone

  • Metoprolol Succinate

  • Metoprolol Tartrate

  • Minoxidil

  • Moexipril HCL

  • Nadolol

  • Nateglinide

  • Nicardipine HCL

  • Nifedipine

  • Perindopril Erbumine

  • Prazosin HCL

  • Propranolol HCL

  • Quinapril HCL

  • Ramipril

  • Reserpine

  • Sotalol HCL

  • Spironolact/Hydrochlorothiazide

  • Spironolactone

  • Terazosin HCL

  • Thyroid

  • Thyroid,Pork

  • Tolazamide

  • Tolbutamide

  • Torsemide

  • Trandolapril

  • Triamterene/Hydrochlorothiazide

  • Verapamil HCL