Eagle Premier Guaranteed Eagle Premier Guaranteed Age Last Birthday

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1 Eagle Premier Series Reference Sheet Issue Ages Face Amounts Death Benefit Eagle Premier Level Non-smoker: Smoker: Companion sale: Age Last Birthday Minimum: $2,000; Maximum: $30,000 (WA: $5,000 or $25,000 for male non-smoker 67-85, male smoker 56-80, female non-smoker and female smoker 63-80) Full death benefit day one Eagle Premier Guaranteed Age Last Birthday Minimum: $2,000 Maximum: $10,000 3-year graded death benefit (2 years in IL, NH, NJ, & WV) Year 1: Death Benefit equals return of premium plus 5% Year 2: Death Benefit equals return of premium plus 10% Year 3: Death Benefit equals 75% of the face amount (100% in IL, NH, NJ, & WV) Year 4: Death Benefit equals 100% of the face amount Additional Benefits Accidental Death Benefit Rider (Series 2172) included at no additional cost Accidental Death Benefit Provision included during the graded period at no additional cost Underwriting Build Chart Height Weight (lbs) Height Product Product Availability Availability Guide Guide Weight (Ibs) As of 11/01/13 As of 11/01/13 State Availability Eagle Premier Eagle Series Premier Telesales Series Telesales Product Product Series AL AK AZ Series AR CA COAL CTAKDEAZDCARFLCAGACOHICTIDDEILDCINFLIAGAKSHI KYIDLAILMEINMDIAMAKSMIKY MNLAMOME MSMD MTMANEMI NVMNHMONJMS NMMT NCNE NDNV OHNH OKNJ ORNMPANCRINDSCOH SDOKTNORTXPAUTRI VASC WASD WVTNWI TX WYUT PRVAVIWA CYWV WI W Eagle Premier Level Level Death Benefit Eagle Premier Level 281 X X X281X X X X XX XX XX X XX XX XX XX XX XX XX XX XX XX XX XX X XX XX XX XX XX X XX XX XX XX XX XX XX X XX XX XX XX XX X XX XX XX XX XX X X X X X Level Death Benefit Eagle Premier Guaranteed Eagle Premier Guaranteed 3-Year Graded Death Benefit 3-Year Graded Death 283Benefit X X X283 X X X XX XX X X XX XX XX XX XX XX XX XX XX XX X XX X XX XX XX X XX X XX XX XX XX XX XX XX X XX XX XX XX XX X XX X XX XX XX X X X X (2 Years in IL, NH, NJ, WV) (2 Years in IL, NH, NJ, WV) Call Americo at to start the application process! Americo Financial Life and Annuity Insurance Comp is authorized to conduct business in the District of Columbia and all states except NY and VT. Eagle Premier Series (Policy Series 281/283) and Accidental Death Benefit Rider (Rider Series 2172) are underwritten by Americo Financial Life and Annuity Insurance Comp and may vary in accordance with state laws. Some products and benefits may not be available in all states. Certain restrictions apply. Consult contract and riders for all limitations and exclusions. This life insurance does not specifically cover funeral goods or services, and may not cover the entire cost of a funeral at the time of death. The beneficiary of this life insurance may use the proceeds for purpose, unless otherwise directed. For agent use only. Not for public use (11/13) Americo

2 Eagle Premier Series TM Agent Guide Policy Series 281/283 î Final expense coverage in one easy call î Two products to fit different situations î Full death benefit payable for accidental death For agent use only. Not for public use (02/14) Americo For agent use only (03/13) Americo

3 Americo Instant Decision Process 1. Prior to Calling Americo s Call Center: î Describe the product in detail to the Insured/Owner/ Payor. If applying for the Eagle Premier Guaranteed Issue explain the graded death benefit. î Pre-qualify the insured Ask the correct state approved health questions to pre-qualify the proposed insured. Determine if the client has existing insurance. Note: replacements are not available. Determine how the client is going to pay for the coverage. Note: only a pre-authorized monthly withdrawal from a checking or savings account is available for payment. î Collect the necessary information The Eagle Premier Series worksheets can be used to help collect all the necessary information. Using the worksheet will help to speed up the call process. î Prepare the Insured, Owner, and Payor Make sure the Insured understands they will be calling Americo to apply for coverage. Explain it is best to answer honestly and with yes and no answers. Let them know that the call will be recorded. Explain that a decision will be given over the phone and payment information will be given at the end of the call. Verify the Payor has their banking information available at the time of the call. 2. Call Americo at î Make sure you have the Insured, Owner, and Payor, on the call with you. The Owner and Payor need to be available if different than Insured. 3. Americo will gather the following information from you (the agent): î Agent Information Name and Agent Number î Insured Information Gender, Name, Address, Years at current address, Phone Number, Birthdate, Age, Place of Birth, and Social Security Number. î Owner Information (if different from Insured) Relationship to Insured, Name, Address, and Years at current address. î Beneficiary Information Number of Beneficiaries, Name(s), Social Security Number(s), Relationship to Insured, and Percent of Share for each Beneficiary (must equal 100%). î Product Information Level or Guaranteed product, Requested Face Amount, Effective Date, Smoker Status, Height and Weight, Automatic Premium Loans. î Premium will then have to be verified. 4. Americo will then ask to talk with the Insured/Owner/Payor to ask the following questions: î Verify all information given by the agent. î Verbal Authorization Allows Americo to access MIB records and Prescription Drug check. Disclosures will be read to Insured. î Replacement Information Questions Do they have existing insurance and are they replacing? î Health Questions All Health Questions will be asked from the state specific application. î Bank Draft Authorization Savings or checking account number, Routing Number, Requested draft date. 5. Americo will provide you and your client a decision over the phone. 6. Americo will then ask for a Verbal Signature to apply for coverage. This will end the call with the Insured/Owner/Payor. 7. Americo will ask for your Agent Statement to end the call. 8. Americo will mail the Insured/Owner/Payor a cover letter with disclosures in the Policy Packet. If the client declines the coverage, disclosures will be sent under a separate letter. Nothing needs to be submitted by you! All information needed was provided over the phone.

4 Because it s more than just final expense insurance, it s a way of life. Americo has a proven history of success in the final expense market. While you re focusing on building a successful final expense business, we re concentrating our efforts on giving you great products, valuable sales tools, relevant technology and outstanding service; all things you ll need to achieve your sales goals. Eagle TM Premier Series Eagle Premier Series whole life insurance products are designed for the final expense market. î Two products for different situations: Eagle Premier Level full death benefit Eagle Premier Guaranteed 3-year graded death benefit 1 ; guaranteed issue 2 î Full death benefit payable for accidental death î Guaranteed level premiums î Rates never increase î Pipe and cigar smokers qualify for non-smoker rates î Every client can qualify for coverage 2 î Coverage cannot be cancelled because of age or health î Face amounts from $2,000 to $30,000 î No medical exams 3 î Simple phone application process We re here to help. Americo Sales Support Eagle Premier Series Telesales Process 1. Call Provide Americo with the Proposed Insured, Owner, and Beneficiary information and product name. 3. Your client will then provide their health information, bank draft and verbal authorizations. 4. Receive an Instant Decision. 5. Give your agent statement. 6. That s it, your done! Benefits î Easy application process! Americo will take all the information to apply over the phone î Quick issue on clean applications î Easy-to-use marketing materials 1 State variations apply. 2 Subject to issue age limits & state availability. 3 Issuance of policy may depend upon answers to medical questions. Eagle Premier Series (Policy Series 281/283) is underwritten by Americo Financial Life and Annuity Insurance Comp (Americo), Kansas City, MO and may vary in accordance with state laws. Some products and benefits may not be available in all states. Certain restrictions apply. Consult policy for all limitations and exclusions.

5 Eagle Premier at a Glance Issue Ages: Eagle Premier Level: Non-smoker: Smoker: Eagle Premier Guaranteed: Age last birthday Minimum Face Amount: $2,000 (In WA, face amounts vary by issue age. See table at the bottom of this page.). Gender: Male/Female (Unisex in MT) Premium Modes: Monthly PAC: Application: Series 5140T Annual Policy Fee: $40 (Policy fee is commissionable on Eagle Premier Level) Additional Information Non-smoker Classification A non-smoker is defined as a person who has not smoked cigarettes for at least 12 months prior to the completion date of the application. Smokeless tobacco, cigar, and pipe smoking qualify as non-smoker. Policy Loans Policy loans may be available. If available, the loan interest will be charged, in advance, at a fixed rate of 7.4% per year, compounded annually. This is equivalent to an effective annual rate of 8.0%, when paid in arrears. Policy loans will impact policy performance. When policy loans and interest on the loans are greater than the policy s cash value, the policy will terminate. State variations apply. Non-Forfeiture Options After the policy has a cash value, and if premium remains unpaid after the grace period, the nonforfeiture options available for Eagle Premier Series are reduced paid-up insurance and cash surrender. The automatic option will be reduced paid-up insurance. State Availability Eagle Premier Level is not available in CA, MN, MT, NY, PA and VT. Eagle Premier Guaranteed is not available in AR, CA, MA, MN, MT, NY, PA, VT and WA. State variations for Eagle Premier Guaranteed: Two-year graded death benefit in IL, NH, NJ & WV. Washington Specific Minimum Face Amounts by Issue Age Minimum Face Amount $5,000 $25,000 Male Nonsmoker Male Smoker Female Nonsmoker Female Smoker

6 Riders & Additional Benefits Accidental Death Benefit Rider Rider Series 2172 For Eagle Premier Level, an Accidental Death Benefit rider equal to the policy face amount will be added automatically to the policy. The accidental death benefit will pay if the insured dies from a bodily injury which is a direct result of an accident. An additional amount will be paid in the event of the insured s death, as a result of an accidental injury while riding as a fare-paying passenger on a common carrier. Accidental Death Provision For Eagle Premier Guaranteed, an accidental death benefit provision is included at no additional cost. With this benefit, if death occurs as the result of an accident during the graded death benefit period, the full death benefit is payable. Underwriting The products are issued on an Accept/Reject basis according to health questions on the application. A Medical Information Bureau (MIB) review and Prescription Drug Check is required. Eagle Premier Level will be issued if: ü All health questions (except for the smoker question) on the application are answered no. ü Height and weight are within guidelines. ü MIB records are clear or provide no information that is inconsistent with health history given on the application. ü Prescription database history is clear or provides no information that is inconsistent with the health history given on the application. Eagle Premier Guaranteed will be issued if: ü No health questions are answered on the application. OR ü Any health questions (except for the smoker question) on the application are answered yes. OR ü Height and weight are outside guidelines. Underwriting Build Chart Height Weight (lbs) Height Weight (Ibs)

7 Rate Charts Eagle Premier Level Annual Premium per $1,000 of Face Amount Issue Age Male FEMALE Non-Smoker Smoker Non-Smoker Smoker 40-50* n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a * Issue ages are available only as a companion sale. Add $40 annual policy fee. In MT use Male rates for Unisex rates. Annual Premium per $1,000 of Face Amount Issue Age Eagle Premier Guaranteed MALE FEMALE Add $40 annual policy fee.

8 Frequently Asked Questions What is an Automatic Premium Loan? An automatic premium loan will be available to your client at no additional cost. An automatic premium loan means that if at the end of the grace period the premium due has not been paid, a policy loan will automatically be made from the policy s cash value to pay the premium. The primary purpose is to prevent unintentional lapse of the policy. If the automatic premium loan is not selected, the cash value will not be used to pay premiums. What is MIB? MIB is an acronym for the Medical Information Bureau. This is a database that houses medical information supplied by insurance companies with permission from proposed insureds. What is Prescription Drug Check? Information gathered from prescription drug databases is frequently used by insurance companies to assist in evaluating risk and streamline underwriting process. How are Premiums drafted? Americo will draft for premiums from a checking or a savings account on the day the application is approved and issued. A specific draft day can be requested but drafting is not available on the 29th, 30th, or 31st. The effective date and the initial draft date will always be the same. If outstanding requirements are not received on a timely basis we will draft for the first and second months premium. If a third month is required, we will call you for approval. Are Companion Sales Allowed? Yes, on Eagle Premier Level product only. Issue ages are available only on the Level product for companion sales (for example, spouses) if one of the insureds is at least 50 years old. These ages are not available on the Guaranteed product. Can Existing Insurance Be Replaced? No. Replacements are not available with Eagle Premier Series.

9 Americo Financial Life and Annuity Insurance Comp 300 W. 11th Street Kansas City, MO About Americo For over 100 years, Americo Life, Inc. s family of insurance companies have been committed to providing the life insurance and annuity products you need to protect your mortgage, family, and future. 1 We listen to what you want from an insurance policy or annuity and do our best to provide a proper solution for your individual situation. Innovative thinking and sound investment decisions have helped us build a strong financial foundation for our business. Today, Americo Financial Life and Annuity Insurance Comp is the lead comp in one of the largest independent, privately held insurance groups in the United States 2, with 660,000 policies, over $32.7 billion of life insurance in force, and $6.0 billion in assets for year-end Americo Life, Inc. is a holding comp and is not responsible for the financial condition or contractual obligations of its affiliate insurance companies. 2 Admitted Assets, Top Life Writers-2013, A.M. Best Co., as of July Information is as of year end 2013 on a consolidated basis for Americo Financial Life and Annuity Insurance Comp and the other life insurance subsidiaries of Americo Life, Inc., unless otherwise indicated. Information is prepared on the basis of generally accepted accounting principles (GAAP). Important Information Americo Financial Life and Annuity Insurance Comp is authorized to do business in the District of Columbia and all states except NY and VT. Products are underwritten by Americo Financial Life and Annuity Insurance Comp (Americo), Kansas City, MO, and may vary in accordance with state laws. Some products and benefits may not be available in all states. Consult policy and riders for all limitations and exclusions. For exact terms and conditions, please refer to the contract. The comp reserves the right to contest coverage for up to two years due to misrepresentations in the application. If the insured, sane or insane, dies by suicide while the contract is in force and within two years (one year in Colorado, Missouri, and North Dakota) after the issue date, the proceeds payable will be limited to the sum of premiums paid, less indebtedness. See Missouri contract for special provisions regarding suicide. Neither Americo Financial Life and Annuity Insurance Comp nor agent representing Americo Financial Life and Annuity Insurance Comp is authorized to give legal or tax advice. Please consult a qualified professional regarding the information and concepts contained in this material. Any illustrations of future value used in a sales presentation are provided only for illustrative purposes. Any such illustration must not be regarded as guaranteed or as estimated future performance unless it is based solely on the minimum guaranteed interest rates.

10 About Americo For over 100 years, Americo Life, Inc. s family of insurance companies has been committed to providing the life insurance and annuity products you need to protect your mortgage, family, and future. 1 We listen to what you want from an insurance policy or annuity and do our best to provide a proper solution for your situation. Innovative thinking has helped us build a strong financial foundation for our business. Americo Financial Life and Annuity Insurance Comp (Americo) is a member of the Americo Life Inc. family of companies. Americo Life Inc., is one of the largest, independent, privately held insurance groups in the United States 2 with over 676,000 policies, over $34 billion of life insurance in force, and $6.1 billion in assets for year-end Americo Life, Inc. is a holding comp and is not responsible for the financial condition or contractual obligations of its affiliate insurance companies. 2 Admitted Assets, Top Life Writers-2012, A.M. Best Co., as of July Information is as of year-end 2012 on a consolidated basis for Americo Financial Life and Annuity Insurance Comp and the other life insurance subsidiaries of Americo Life, Inc., unless otherwise indicated. Information is prepared on the basis of generally accepted accounting principles (GAAP). Important Notices Americo Financial Life and Annuity Insurance Comp is authorized to conduct business in the District of Columbia and all states except NY and VT. Ultra Protector Series (Policy Series 281/283), Accelerated Benefit Payment Rider (Rider Series 2146), Accidental Death Benefit Rider (Rider Series 2175) and Children s Term Rider (Rider Series 2147) are underwritten by Americo Financial Life and Annuity Insurance Comp (Americo), Kansas City, MO, and may vary in accordance with state laws. Some products and benefits may not be available in all states. Some riders are optional and available for an additional cost. Certain restrictions and variations apply. Consult policy and riders for all limitations and exclusions. This life insurance does not specifically cover funeral goods or services, and may not cover the entire cost of your funeral at the time of your death. The beneficiary of this life insurance may use the proceeds for purpose, unless otherwise directed. The comp reserves the right to contest coverage for up to two years due to misrepresentations in the application. If the insured, sane or insane, dies by suicide while the contract is in force and within two years (one year in Colorado, Missouri, and North Dakota) after the issue date, the proceeds payable will be limited to the sum of premiums paid, less indebtedness. See Missouri contract for special provisions regarding suicide. Neither Americo Financial Life and Annuity Insurance Comp, nor agent representing Americo Financial Life and Annuity Insurance Comp is authorized to give legal or tax advice. Please consult a qualified, professional legal or tax advisor regarding the information and concepts contained in this material. Permanent Final Expense Whole Life Insurance Eagle Premier Series Policy Series 281/ (03/14)

11 Individual, Permanent Whole Life Insurance Protection From $2,000 to $30,000 Death benefit up to $30,000 You decide how much protection you need and can comfortably afford. Choose a death benefit of $2,000 or up to $30, Individual, Permanent Protection It may be one of the safest kinds of protection you can buy! It s safe because you own the policy. And as long as you pay your premiums, your coverage is guaranteed for life. Your Rate Does Not Increase The affordable monthly rate you start at will be the same monthly rate you ll pay for the life of the policy. Your rate will not increase with age or changes in health. Your Coverage Will Not Decrease or be Cancelled Because of Age or Health This is permanent whole life protection. The amount of your death benefit does not decrease as you get older. And, as long as you make your premium payments when due, you cannot lose this valuable protection because you get older or because your health changes. No Physical Exam Required Your acceptance is based on the information you provide during the application process. Depending on the policy, you will only need to answer a few medical questions. There are no costly or embarrassing physical exams to take. Issuance of policy may depend upon answers to medical questions. Protection From the Very First Day You are protected from the very first day your policy goes into effect. And, if you qualify for Eagle Premier Level, your full death benefit is available as soon as your policy is issued. If you don t qualify for Eagle Premier Level, you may receive an Eagle Premier Guaranteed policy. With Eagle Premier Guaranteed, the death benefit is graded for the first three policy years. 2 Builds Cash Value After your policy has been in force for a specified period of time, it builds cash value every year. This is your money that you can leave to grow or borrow to use as you see fit. Choice of Beneficiary and Payment Date Pick who you d like as your beneficiary and what date you would like to make your premium payments. Accidental Death Benefit Rider With Eagle Premier Level, an Accidental Death Benefit Rider (Rider Series 2175) is included at no additional cost. This rider provides an additional benefit of two times the base death benefit if the insured dies as a result of an accidental bodily injury within 90 days of the injury. In addition, it will provide an additional payment of three times the base death benefit in the event the death is a result of accidental injury while riding as a fare-paying passenger in a Common Carrier. Accidental Death Benefit Provision An Accidental Death Benefit provision is included with Eagle Premier Guaranteed policies at no additional cost. With this extra protection, if death occurs as the result of accidental bodily injury in the first three years and within 90 days of the injury, the full death benefit is payable. Not available in all states. Costs to Consider Use this worksheet to estimate some of the future financial obligations your loved ones may face. Credit Card Balances Other Outstanding Debt College Costs Funeral Expenses: Funeral Home Cemetery Plot Transportation Casket & Vault Church & Flowers Medical Expenses Probate Other TOTAL Proceeds from your Eagle Premier Series policy may be used for purpose. 1 Depends on policy selected and eligibility at the time of application. 2 State variations apply.

12 Eagle Premier Series Worksheet For use in all states except CA, CT, FL, MN, NY, PA, and VT. This worksheet is to be used to collect information prior to contacting Americo s Call Center. Once completed, call the toll-free number at All participants (Agent, Proposed Insured, Owner, and Payor) must be on the phone at the time of the call. All calls are recorded. This worksheet contains sensitive information and should be kept in a secure location for your records or destroyed. Agent Information Name: Agent ID #: Proposed Insured Information Issue State: Date of Birth: / / Male Female Name (First, MI, Last): Mailing Address: Street Address (If Mailing Address is a PO BOX): If less than 5 years at current address, list prior address: Phone Number: - - SSN or Taypayer ID: Place of Birth (City, State, Country): Owner Information (If different than the Proposed Insured) Name (First, MI, Last): Relationship to Proposed Insured: SSN or Taypayer ID: Mailing Address: Street Address (If Mailing Address is a PO BOX): Beneficiary Information (% of Share must total 100%. If shares are not given, they will be equal.) Primary Contingent % of Share: Name (First, MI, Last): Date of Birth: / / Phone Number: - - Relationship to Proposed Insured: Primary Contingent % of Share: Name (First, MI, Last): Date of Birth: / / Phone Number: - - Relationship to Proposed Insured: Product Information (Not all products are available in all states. See Product Availability Guide for state availability.) Level Guaranteed Face Amount $ Effective Date (If Not Current Date): / / Monthly Premium $ Automatic Premium Loan If applying for Eagle Premier Level, complete the following information: 1. Cigarette Smoker Non-Smoker 2. Height ' " 3. Weight (in pounds) Payor Information (Complete only when the Payor is different than the Proposed Insured and Owner.) Name (First, MI, Last): Relationship to Proposed Insured: Mailing Address: Street Address (If Mailing Address is a PO BOX): Bank Information Name of Financial Institution: Checking Savings Routing Number: Account Number: Notes: Policy Number (Will be provided at the end of the call.) For agent use only. Not for public use (03/14) Americo

13 REPLACEMENT INFORMATION For reference only. Do not return to Americo. 1. Is there existing life insurance or annuity coverage on the life of Proposed Insured?... Yes No If Yes, provide information in the table below and answer question 2. If No, skip question 2, and proceed to the next applicable section. Accidental Proposed Insured s Name (Last, First, Middle Initial) Comp Owner (Last, First, Middle Initial) Amount Death Benefit Policy Date 2. Will the life insurance applied for replace, or otherwise reduce in value, existing life insurance or annuity now in force?... Yes No Complete the replacement form(s) in accordance with applicable state replacement regulations. Replacement forms must be submitted with the application. PROPOSED INSURED HEALTH INFORMATION 1. Have You smoked cigarettes within the last twelve (12) months?... Yes No 2. Height: 3. Weight: 4. Have You ever been diagnosed, treated, tested positive, or been given medical advice, or prescribed medication Yes No by a member of the medical profession for: a. Alzheimer s disease, dementia, memory loss, muscular dystrophy, or ALS (Lou Gehrig s disease)?... b. Congestive heart failure or cardiomyopathy, chronic kidney disease or kidney failure, or received kidney dialysis?... c. Cirrhosis of the liver, liver failure or other liver diseases (excluding Hepatitis A, B, or C)?... d. Emphysema, chronic obstructive pulmonary disease (COPD), or other chronic respiratory or lung problem, excluding allergies or asthma?.. e. Metastatic cancer (cancer that has spread to other parts of the body)?... f. Two (2) or more occurrences of cancer of kind or a reoccurrence of a previous cancer?... g. AIDS, ARC, or HIV? In the past twenty-four (24)months, have You been diagnosed, treated, tested positive, or been given medical advice by a member of the medical profession for: a. Internal cancer or malignant melanoma (not basal cell skin cancer)?... b. Complications of diabetes, including amputation, retinopathy (eye disease), nephropathy (kidney disease), neuropathy, insulin shock, or diabetic coma?... c. Chronic hepatitis or alcoholic hepatitis? In the past twenty-four (24) months, have You received a diagnosis, been treated, received medical treatment or counseling, or been prescribed medication by a member of the medical profession for drug or alcohol abuse/dependency or addiction? the last twelve (12) months, have You been advised to have tests, surgery or hospitalization (except for those related to HIV or AIDS), which have not been completed, or waiting for a medical diagnosis or results of medical tests or procedures which have not been received? In the past twelve (12) months, have You been diagnosed, treated, tested positive, prescribed medication, or been given medical advice by a member of the medical profession for: a. Angioplasty (balloon procedure), stent placement, or heart bypass surgery?... b. Stroke; Heart attack, heart valve disorder, coronary disease, angina (chest pain), or heart disorder (excluding heart murmurs, rhythm disorders, and hypertension)? Have You received advice from a member of the medical profession to have, are You waiting for, or have You ever received, an organ or tissue transplant? Are You now, or within the past six (6) months have you been: a. Hospitalized for 48 hours or more, bedridden or confined to or living in a nursing facility or correctional facility?... b. Receiving or been advised by a member of the medical profession to receive hospice care?... c. Receiving home health care for a chronic or debilitating condition?... d. Receiving assistance with activities of daily living, including eating, bathing, toileting, or dressing due to a chronic or debilitating condition?... e. Confined to a wheelchair or using a walker for a chronic illness (except in the case of a temporary condition that is expected to last three (3) months or less)?... f. Using oxygen to assist in breathing? Have You been diagnosed with a terminal illness that is expected to result in death within twenty-four (24) months?... ADDITIONAL QUESTIONS FOR APPLICANTS AGE ONLY Yes No 12. the past twenty-four (24) months, have You been convicted of, or pled guilty or no contest to, a felony? the past twenty-four (24) months, have You been diagnosed, treated or tested positive, or given medical advice by a member of the medical profession for: a. Bipolar disorder, schizophrenia, manic or clinical depression, psychosis, mental incapacity, post-traumatic stress disorder or suicidal thoughts?... b. Brain tumor?... c. Huntington s disease? the past twenty-four (24) months, have You used narcotics (other than as prescribed by a member of the medical profession), amphetamines, hallucinogens, heroin, or cocaine? the past twelve (12) months, have You been convicted of or pled guilty or no contest to driving while impaired, intoxicated or under the influence of drugs or alcohol, or had Your driver s license suspended or revoked for reason? the past twelve (12) months, have You been diagnosed, tested positive, or been given medical advice by a member of the medical profession for chronic pancreatitis? Do You currently have felony charges pending against You, or are You currently on probation or parole?... For Americo agent use Financial only. Not for Life public and use. Annuity Insurance Comp Eagle Premier Home Series Office: (Policy Series Dallas, 281/283) Texas is underwritten Administrative by Americo Financial Office: Life PO and BOX Annuity , Insurance Kansas Comp, City, Kansas MO City, MO. Series 5140T ICC T (03/14)@Americo Page 1 of 3

14 Eagle Premier Series Monthly PAC Rates P$40 annual policy fee included PAnnual Premium = Monthly PAC Premium * Male Non-smoker Eagle Premier Level (281) Issue Age $2,000 $5,000 $7,000 $8,000 $9,000 $10,000 $11,000 $12,000 $15,000 $20,000 $25,000 $30,000 Issue Age Female Non-smoker Eagle Premier Level (281) Issue Age $2,000 $5,000 $7,000 $8,000 $9,000 $10,000 $11,000 $12,000 $15,000 $20,000 $25,000 $30,000 Issue Age PAC Rates for Eagle Premier Level (01/14) Americo For agent use only. Not for public use. Policy Series 281/283

15 Eagle Premier Series Monthly PAC Rates P$40 annual policy fee included PAnnual Premium = Monthly PAC Premium * PAC Rates for Eagle Premier Level Male Smoker Eagle Premier Level (281) Issue Age $2,000 $5,000 $7,000 $8,000 $9,000 $10,000 $11,000 $12,000 $15,000 $20,000 $25,000 $30,000 Issue Age Female Smoker Eagle Premier Level (281) Issue Age $2,000 $5,000 $7,000 $8,000 $9,000 $10,000 $11,000 $12,000 $15,000 $20,000 $25,000 $30,000 Issue Age

16 Eagle Premier Series Monthly PAC Rates P$40 annual policy fee included PAnnual Premium = Monthly PAC Premium * Male Eagle Premier Guaranteed (283) Issue Age $2,000 $3,000 $4,000 $5,000 $6,000 $7,000 $8,000 $9,000 $10,000 Issue Age Female Eagle Premier Guaranteed (283) Issue Age $2,000 $3,000 $4,000 $5,000 $6,000 $7,000 $8,000 $9,000 $10,000 Issue Age PAC Rates for Eagle Premier Guaranteed

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18 Premier Series Eagle TM Prescription Drug Guide 2014 Edition For agent use only. Not for public use (04/14)

19 Prescription Drug Guide This Prescription Drug Guide is used in conjunction with Americo s underwriting guidelines and does not reflect the full underwriting standards of Americo or all prescription drugs considered by Americo. This Guide provides a list of common drugs, their uses, and eligible Eagle Premier Series products available to an applicant taking one of the listed drugs. Americo products listed below under the column are not a guarantee of policy issuance, and prescription drug combinations may result in ineligibility. Further, prescription drug used in combination with a related or unrelated medical condition could result in ineligibility. Each application is reviewed based on the circumstances and conditions represented therein and may involve additional requirements. Both this Guide and the full underwriting guidelines used by Americo are subject to change. Note: The brand name drug is in ALL CAPS and its generic equivalent is next to it in lowercase letters. This guide allows you to search either by generic or brand name. p. 2 Drug Name A/B OTIC Ear pain Eagle Level abacavir (ZIAGEN) HIV/AIDS abacavir/lamivudine (EPZICOM) HIV/AIDS ABILIFY (aripiprazole) Psychotic disorders 24 months Eagle Level; decline ABSORBINE ARTHRITIS Topical arthritis pain treatment Eagle Level ABSTRAL (fentl) sublingual tablets Cancer pain 24 months acamprosate (CAMPRAL) Alcohol dependency treatment 24 months acarbose (PRECOSE) Diabetes Eagle Level (with no diabetic complications) ACCOLATE (zafirlukast) Asthma Eagle Level ACCUNEB (albuterol) Asthma Eagle Level ACCUPRIL (quinapril) Hypertension Eagle Level ACCUZYME (papain and urea) Dermatological treatment Eagle Level acebutolol HCl (SECTRAL) Hypertension Eagle Level acebutolol HCl (SECTRAL) Arrhythmia Eagle Level ACEON (perindopril) Hypertension Eagle Level ACEON (perindopril) Coronary artery disease 12 months acetaminophen with codeine #3 (TYLENOL WITH CODEINE #3) Pain relief - narcotic Eagle Level ACETASOL HC (acetic acid w/hydrocortisone) External ear infection Eagle Level acetazolamide (DIAMOX) Congestive heart failure acetazolamide (DIAMOX) Seizures Eagle Level acetazolamide (DIAMOX) Mountain sickness Eagle Level acetazolamide (DIAMOX) Glaucoma Eagle Level ACETIC ACID External ear infection Eagle Level acetic acid/aluminum acetate (DOMEBORO) External ear infection Eagle Level acetic acid/hydrocortisone (ACETASOL HC) External ear infection Eagle Level acetylcysteine (MUCOMYST) Emphysema acetylcysteine (MUCOMYST) Tuberculosis acetylcysteine (MUCOMYST) Pneumonia/bronchitis Eagle Level acetylcysteine (MUCOMYST) Cystic fibrosis ACLOVATE (alclometasone dipropionate) Dermatological treatment Eagle Level ACTIGALL (ursodiol) Gallstones Eagle Level ACTIGALL (ursodiol) Liver cirrhosis Eagle Level ACTIQ (fentl citrate) lozenge Cancer pain 24 months ACTIVELLA (estradiol/norethindrone) Menopausal symptoms Eagle Level

20 Drug Name ACTONEL (risedronate) Osteoporosis Eagle Level ACTOPLUS MET (metformin and pioglitazone) Diabetes Eagle Level (with no diabetic complications) ACTOS (pioglitazone) Diabetes Eagle Level (with no diabetic complications) ACULAR LS Eye drops Eagle Level acyclovir (ZOVIRAX) Shingles/chickenpox/genital herpes Eagle Level ADALAT (nifedipine) Hypertension Eagle Level adalimumab (HUMIRA) Rheumatoid arthritis/juvenile psoriatic arthritis Eagle Level adalimumab (HUMIRA) Crohn s disease Eagle Level adalimumab (HUMIRA) Ankylosing spondylitis Eagle Level adalimumab (HUMIRA) Plaque psoriasis Eagle Level ADDERALL (dextroamphetamine/amphetamine) ADHD/narcolepsy Eagle Level adefovir (HEPSERA) Hepatitis B 24 months ADVAIR DISKUS (fluticasone propionate/salmeterol) Asthma Eagle Level ADVAIR DISKUS (fluticasone propionate/salmeterol) Chronic obstructive pulmonary disease (COPD) Eagle Level (if diagnosed as chronic Eagle Guaranteed) ADVICOR (niacin/lovastatin) Elevated cholesterol Eagle Level AEROBID (flunisolide) Asthma Eagle Level AFEDITAB (nifedipine) Hypertension Eagle Level AGGRENOX (aspirin/dipyridamole) Stroke/TIA 12 months AGRYLIN (anagrelide HCl) Cancer 24 months albuterol (ACCUNEB, PROAIR HFA, PROVENTIL, VENTOLIN) albuterol/ipratropium (COMBIVENT, DUONEB) Asthma Eagle Level Chronic obstructive pulmonary disease (COPD) alclometasone dipropionate (ACLOVATE) Dermatological treatment Eagle Level ALDACTAZIDE (hydrochlorothiazide/spironolactone) Hypertension Eagle Level ALDACTAZIDE (hydrochlorothiazide/spironolactone) Liver cirrhosis ALDACTAZIDE (hydrochlorothiazide/spironolactone) Congestive heart failure ALDACTAZIDE (hydrochlorothiazide/spironolactone) Kidney disease ALDACTONE (spironolactone) Hyperaldosteronism/low potassium Eagle Level ALDACTONE (spironolactone) Hypertension Eagle Level ALDACTONE (spironolactone) Liver cirrhosis ALDACTONE (spironolactone) Congestive heart failure ALDACTONE (spironolactone) Kidney disease ALDARA (imiquimod) Dermatological treatment Eagle Level ALDOMET (methyldopa) Hypertension Eagle Level ALINIA Gastrointestinal infection Eagle Level aliskiren (TEKTURNA) Hypertension Eagle Level aliskiren/hydrochlorothiazide (TEKTURNA HCT) Hypertension Eagle Level ALLOPURINOL Gout Eagle Level ALLOPURINOL Cancer treatment-related uric acid elevation 24 months ALPHAGAN (brimonidine tartrate) Glaucoma Eagle Level p. 3

21 Prescription Drug Guide p. 4 Drug Name ALPRAZOLAM Anxiety/panic disorder Eagle Level ALTABAX Dermatological treatment Eagle Level ALTACE (ramipril) Hypertension Eagle Level ALTACE (ramipril) Congestive heart failure ALTOCOR (lovastatin) Elevated cholesterol Eagle Level ALTOPREV (lovastatin) Elevated cholesterol Eagle Level ALUPENT (metaproterenol sulfate) Asthma Eagle Level ALUPENT (metaproterenol sulfate) Emphysema amantadine HCl (SYMMETREL) Parkinson s disease Eagle Level amantadine HCl (SYMMETREL) Drug-induced movement disorders Eagle Level AMARYL (glimepiride) Diabetes Eagle Level (with no diabetic complications) AMBIEN (zolpidem tartrate) Insomnia Eagle Level AMCINONIDE Dermatological treatment Eagle Level AMDRY-D Cough/cold/allergies Eagle Level amiloride (MIDAMOR) Congestive heart failure amiloride (MIDAMOR) Hypertension Eagle Level AMINOPHYLLINE Asthma Eagle Level AMINOPHYLLINE Emphysema/chronic obstructive pulmonary disease (COPD) amiodarone (CORDARONE, PACERONE) Heart arrhythmia Eagle Level AMITIZA (lubiprostone) Constipation Eagle Level AMITRIPTYLINE HCL Depression 24 months Eagle Level amlodipine (NORVASC) Hypertension Eagle Level amlodipine (NORVASC) Coronary artery disease 12 months amlodipine/atorvastatin (CADUET ) Hypertension Eagle Level amlodipine/atorvastatin (CADUET ) Coronary artery disease 12 months amlodipine/benazepril (LOTREL) Hypertension Eagle Level amlodipine/olmesartan (AZOR) Hypertension Eagle Level amlodipine/valsartan (EXFORGE) Hypertension Eagle Level ammonium lactate (LAC-HYDRIN) Dermatological treatment Eagle Level AMOXICILLIN Antibiotic Eagle Level amoxicillin/potassium clavulanate (AUGMENTIN) Antibiotic Eagle Level AMPHOTERICIN B Antifungal treatment Eagle Level AMPICILLIN Antibiotic Eagle Level ANAFRANIL (clomipramine HCl) Obsessive compulsive disorder Eagle Level anagrelide HCl (AGRYLIN) Cancer 24 months ANAPLEX DMX Cough/cold/allergies Eagle Level anastrozole (ARIMIDEX) Cancer 24 months ANDROGEL Testosterone replacement Eagle Level ANEMAGEN Iron supplementation Eagle Level ANIMI-3 Vitamin supplement Eagle Level ANTABUSE Alcohol dependency treatment 24 months ANTARA (fenofibrate) Elevated cholesterol/triglycerides Eagle Level

22 Drug Name ANUCORT-HC Hemorrhoidal treatment Eagle Level APEXICON E Dermatological treatment Eagle Level APIDRA (insulin glulisine) Diabetes Eagle Level (with no diabetic complications) APLENZIN (bupropion) Depression Eagle Level aprepitant (EMEND) aprepitant (EMEND) Nausea/vomiting prevention pre-surgery Nausea/vomiting prevention pre-chemotherapy Eagle Level 24 months APRESOLINE (hydralazine HCl) Hypertension Eagle Level ARAVA (leflunomide) Rheumatoid arthritis Eagle Level AREDIA (pamidronate) Cancer 24 months AREDIA (pamidronate) Paget s bone disease Eagle Level arformoterol inhalation (BROVANA) Chronic obstructive pulmonary disease (COPD) ARICEPT (donepezil) Alzheimer s disease ARIMIDEX (anastrozole) Cancer 24 months aripiprazole (ABILIFY) Psychotic disorders 24 months Eagle Level; decline ARIXTRA (fondaparinux sodium) Presurgical PREVENTION of blood clot Eagle Level ARIXTRA (fondaparinux sodium) Treatment of blood clot Eagle Level ARIXTRA (fondaparinux sodium) Treatment of pulmonary embolism (clot) Eagle Level ARMOUR THYROID Thyroid replacement Eagle Level AROMASIN (exemestane) Cancer 24 months ARTANE (trihexyphenidyl) Parkinson s disease Eagle Level ARTHROTEC 75 Pain relief - anti-inflammatory Eagle Level ASACOL (mesalamine) Ulcerative colitis Eagle Level ASCOMP/CODEINE Tension headache Eagle Level ASMANEX Asthma Eagle Level ASPIRIN/CODEINE Pain relief Eagle Level aspirin/dipyridamole (AGGRENOX) Stroke/TIA 12 months ASTELIN (azelastine) Nasal spray Eagle Level ATACAND (candesartan) Hypertension Eagle Level ATACAND (candesartan) Congestive heart failure ATACAND HCT (candesartan/hydrochlorothiazide) Hypertension Eagle Level atazanavir (REYATAZ) HIV-related anemia atenolol (TENORMIN) Hypertension Eagle Level atenolol (TENORMIN) Angina 12 months atenolol (TENORMIN) Heart attack 12 months atenolol/chlorthalidone (TENORETIC) Hypertension Eagle Level ATIVAN (lorazepam) Anxiety Eagle Level atorvastatin (LIPITOR) Elevated cholesterol Eagle Level ATRIPLA (efavirenz/emtricitabine/tenofovir disoproxil fumarate) HIV/AIDS ATROPINE SULFATE Eye drops Eagle Level p. 5

23 Prescription Drug Guide p. 6 Drug Name ATROVENT HFA (ipratropium bromide HFA) ATROVENT NASAL SPRAY (ipratropium bromide nasal spray) Chronic obstructive pulmonary disease (COPD)/emphysema Allergic and non-allergic nasal symptoms Eagle Level ATUSS DS Cough/cold/allergies Eagle Level AUGMENTED BETAMETHASONE DIPROPIONATE Dermatological treatment Eagle Level AUGMENTIN (amoxicillin/potassium clavulanate) Antibiotic Eagle Level AVALIDE (irbesartan/hydrochlorothiazide) Hypertension Eagle Level AVANDAMET (metformin/rosiglitazone) Diabetes Eagle Level (with no diabetic complications) AVANDARYL (glimepiride/rosiglitazone) Diabetes Eagle Level (with no diabetic complications) AVANDIA (rosiglitazone) Diabetes Eagle Level (with no diabetic complications) AVAPRO (irbesartan) Hypertension Eagle Level AVAPRO (irbesartan) Diabetic kidney disease AVELOX (moxifloxacin) Antibiotic Eagle Level AVINZA (morphine sulfate) Moderate to severe pain Eagle Level AVODART (dutasteride) Benign prostatic hypertrophy Eagle Level AVONEX (interferon beta-1a) Multiple sclerosis Eagle Level AXID (nizatidine) Ulcers/esophagitis Eagle Level AZASAN (azathioprine) Kidney transplant rejection prevention AZASAN (azathioprine) Rheumatoid arthritis Eagle Level AZASITE Ophthalmic agent Eagle Level azathioprine (IMURAN, AZASAN) Kidney transplant rejection prevention azathioprine (IMURAN, AZASAN) Rheumatoid arthritis Eagle Level azelastine (ASTELIN) Nasal spray Eagle Level AZELEX Dermatological treatment Eagle Level AZILECT (rasagiline) Parkinson s disease Eagle Level AZITHROMYCIN Antibiotic Eagle Level AZMACORT (triamcinolone oral inhalation) Asthma Eagle Level AZOPT Ophthalmic agent Eagle Level AZOR (amlodipine/olmesartan) Hypertension Eagle Level BACITRACIN Dermatological treatment Eagle Level BACITRACIN/POLYMYXIN B Ophthalmic agent Eagle Level BACLOFEN Muscular sclerosis Eagle Level BACLOFEN Spasticity from spinal cord injury Eagle Level BACTROBAN Dermatological antibiotic Eagle Level BACTROBAN NASAL Nasal infection Eagle Level BARACLUDE (entecavir) Hepatitis B 24 months beclomethasone (QVAR) Asthma Eagle Level BECONASE AQ Nasal agent Eagle Level BELLADONNA ALKALOIDS/PHENOBARBITAL Ulcers Eagle Level benazepril HCl (LOTENSIN) Hypertension Eagle Level Eagle Level (if diagnosed as chronic Eagle Guaranteed)

24 Drug Name BENICAR HCT (olmesartan) Hypertension Eagle Level BENTYL (dicyclomine) Irritable bowel syndrome Eagle Level BENZACLIN Dermatological treatment Eagle Level BENZONATATE Cough/cold/allergies Eagle Level benztropine mesylate (COGENTIN) Parkinson s disease Eagle Level BEPREVE Ophthalmic agent Eagle Level BETAMETHASONE DIPROPIONATE Dermatological treatment Eagle Level BETAPACE (sotalol) Heart arrhythmia Eagle Level BETHANECHOL CHLORIDE Urinary spasm/retention Eagle Level BETIMOL Ophthalmic agent Eagle Level BETOPTIC-S Eye drops Eagle Level BIAXIN XL Antibiotic Eagle Level bicalutamide (CASODEX) Cancer 24 months BICILLIN L-A Antibiotic Eagle Level BIDIL (isosorbide dinitrate and hydralazine hydrochloride) Congestive heart failure BILTRICIDE Worm infection Eagle Level BIONECT Dermatological treatment Eagle Level BISACODYL EC Constipation Eagle Level BISMATROL Diarrhea Eagle Level BISOPROLOL FUMARATE Hypertension Eagle Level BISOPROLOL FUMARATE/HCTZ Hypertension Eagle Level BLEPHAMIDE Eye drops Eagle Level BONIVA (ibandronate) Osteoporosis Eagle Level BOTOX (onabotulinumtoxina) Spasticity/multiple indications Eagle Level BRETHINE (terbutaline) Asthma/bronchitis Eagle Level BRETHINE (terbutaline) Emphysema BRICANYL (terbutaline) Asthma/bronchitis Eagle Level BRICANYL (terbutaline) Emphysema brimonidine tartrate (ALPHAGAN) Glaucoma Eagle Level BROMETANE DX Cough/cold/allergies Eagle Level BROVANA (arformoterol inhalation) Chronic obstructive pulmonary disease (COPD) BUDEPRION (bupropion) Depression 24 months Eagle Level budesonide/formoterol (SYMBICORT) Asthma Eagle Level budesonide/formoterol (SYMBICORT) Chronic obstructive pulmonary disease (COPD) bumetanide (BUMEX) Congestive heart failure bumetanide (BUMEX) Liver disease bumetanide (BUMEX) Kidney disease BUMEX (bumetanide) Congestive heart failure BUMEX (bumetanide) Liver disease BUMEX (bumetanide) Kidney disease BUPROBAN (bupropion) Smoking cessation 12 months Smoking rates (Eagle Level) p. 7

25 Prescription Drug Guide p. 8 Drug Name bupropion (APLENZIN, BUDEPRION, FORFIVO, WELLBUTRIN) Depression 24 months Eagle Level bupropion (BUPROBAN, ZYBAN) Smoking cessation 12 months Smoking rates (Eagle Level) BUSPAR (buspirone HCl) Anxiety Eagle Level buspirone HCl (BUSPAR) Anxiety Eagle Level BUTALBITAL/ACETAMINOPHEN/CAFFEINE/ CODEINE Tension headache Eagle Level BUTORPHANOL TARTRATE Pain relief Eagle Level BYETTA (exenatide) Diabetes Eagle Level (with no diabetic complications) BYSTOLIC (nebivolol) Hypertension Eagle Level CABERGOLINE Hyperprolactinemic disorders Eagle Level CADUET (amlodipine besylate, atorvastatin calcium) Hypertension Eagle Level CADUET (amlodipine besylate, atorvastatin calcium) Coronary artery disease 12 months CALAMINE Dermatological treatment Eagle Level CALAN (verapamil) Hypertension Eagle Level CALAN (verapamil) Angina 12 months CALAN (verapamil) Arrhythmia Eagle Level CALCIFOLIC-D Mineral/electrolyte replacement Eagle Level calcitonin (MIACALCIN) Osteoporosis Eagle Level calcitonin (MIACALCIN) Paget s bone disease Eagle Level calcitriol (ROCALTROL) Calcium replacement in PRIMARY parathyroid disease Eagle Level calcitriol (ROCALTROL) Kidney failure CALCIUM ACETATE Hyperphosphatemia in kidney failure CALCIUM CARBONATE Antacid Eagle Level CALCIUM/VITAMIN D Vitamin/mineral supplement Eagle Level CAL-NATE Vitamin supplement Eagle Level CAMPRAL (acamprosate) Alcohol dependency treatment 24 months candesartan (ATACAND) Hypertension Eagle Level candesartan (ATACAND) Congestive heart failure candesartan hydrochlorothiazide (ATACAND HCT) Hypertension Eagle Level capecitabine (XELODA) Cancer 24 months CAPOTEN (captopril) Hypertension Eagle Level CAPOTEN (captopril) Congestive heart failure CAPOTEN (captopril) Diabetic kidney disease CAPOZIDE (captopril/hydrochlorothiazide) Hypertension Eagle Level captopril (CAPOTEN) Hypertension Eagle Level captopril (CAPOTEN) Congestive heart failure captopril (CAPOTEN) Diabetic kidney disease captopril/hydrochlorothiazide (CAPOZIDE) Hypertension Eagle Level CARAC Dermatological treatment Eagle Level carbamazepine (CARBATROL, TEGRETOL) Epilepsy Eagle Level carbamazepine (CARBATROL, TEGRETOL) Facial nerve disorder Eagle Level CARBATROL (carbamazepine) Epilepsy Eagle Level

26 Drug Name CARBATROL (carbamazepine) Facial nerve disorder Eagle Level CARBATUSS-CL Cough/cold/allergies Eagle Level carbidopa/levodopa (SINEMET) Parkinson s disease Eagle Level CARDIZEM (diltiazem) Hypertension Eagle Level CARDIZEM (diltiazem) Angina 12 months CARDOXIN (digoxin) Heart failure CARDURA (doxazosin mesylate) Benign prostatic hypertrophy Eagle Level CARDURA (doxazosin mesylate) Hypertension Eagle Level CARISOPRODOL Muscular pain Eagle Level CARISOPRODOL/ASPIRIN Muscular pain Eagle Level CARTIA XT (diltiazem) Hypertension Eagle Level CARTIA XT (diltiazem) Angina 12 months carvedilol (COREG) Hypertension Eagle Level carvedilol (COREG) Congestive heart failure CASODEX (bicalutamide) Cancer 24 months CATAFLAM (diclofenac) Pain relief - anti-inflammatory Eagle Level CATAPRES (clonidine HCl) Hypertension Eagle Level CAVERJECT (alprostadil) Erectile dysfunction Eagle Level CEDAX Antibiotic Eagle Level CEFACLOR Antibiotic Eagle Level CEFADROXIL Antibiotic Eagle Level CEFPODOXIME PROXETIL Antibiotic Eagle Level CEFTRIAXONE SODIUM Antibiotic Eagle Level CEFUROXIME AXETIL Antibiotic Eagle Level CEFZIL Antibiotic Eagle Level CELEBREX (celecoxib) Pain relief - anti-inflammatory Eagle Level celecoxib (CELEBREX) Pain relief - anti-inflammatory Eagle Level CELESTONE Multiple indications - corticosteroid Eagle Level CELEXA (citalopram hydrobromide) Depression Eagle Level CELLCEPT (mycophenolate) Organ transplant rejection prevention CELLUVISC Eye drops Eagle Level CELONTIN (methsuximide) Seizures Eagle Level CENESTIN Menopausal symptoms Eagle Level CEPHADYN Pain relief - nonnarcotic Eagle Level CEPHALEXIN Antibiotic Eagle Level CEREFOLIN Vitamin Eagle Level CERON-DM Cough/cold/allergies Eagle Level CETAPHIL Dermatological treatment Eagle Level CHANTIX (varenicline) Smoking cessation 12 months smoking rates (Eagle Level) CHERATUSSIN AC Cough/cold/allergies Eagle Level CHLORAL HYDRATE Insomnia Eagle Level chlordiazepoxide (LIBRIUM) Alcohol withdrawal 24 months p. 9

27 Prescription Drug Guide p. 10 Drug Name chlordiazepoxide/amitriptyline (LIMBITROL) Depression/anxiety 24 months Eagle Level; decline chlordiazepoxide/clidinium (LIBRAX) Irritable bowel syndrome Eagle Level chlorhexidine gluconate (PERIDEX) Antiseptic rinse Eagle Level chloroquine phosphate Malaria Eagle Level chlorpheniramine/pseudoephedrine CR (DYNAHIST ER) Cold/cough/allergies Eagle Level chlorpromazine HCl (THORAZINE) Schizophrenia/psychotic disorder 24 months Eagle Level; decline chlorthalidone (HYDONE, HYGROTON, THALITONE) Hypertension Eagle Level chlorthalidone (HYDONE, HYGROTON, THALITONE) Congestive heart failure chlorthalidone (HYDONE, HYGROTON, THALITONE) Liver cirrhosis chlorthalidone (HYDONE, HYGROTON, THALITONE) Edema related to estrogen therapy Eagle Level chlorzoxazone (PARAFON FORTE DSC) Musculoskeletal pain Eagle Level cholestyramine (QUESTRAN) Elevated cholesterol Eagle Level CHOLINE MAGNESIUM TRISALICYLATE Pain relief - nonnarcotic Eagle Level CHORIONIC GONADOTROPIN Hormonal treatment Eagle Level CHROMAGEN Dietary supplement Eagle Level CIALIS (tadalafil) Erectile dysfunction Eagle Level CICLOPIROX OLAMINE Dermatological treatment Eagle Level cilostazol (PLETAL) Circulatory disease Eagle Level cimetidine (TAGAMET) Heartburn Eagle Level cinacalcet (SENSIPAR) Primary parathyroid disease Eagle Level cinacalcet (SENSIPAR) Parathyroid cancer 24 months cinacalcet (SENSIPAR) Kidney disease CIPRO (ciprofloxacin) Antibiotic Eagle Level CIPRODEX External ear infection Eagle Level ciprofloxacin HCL (CIPRO) Antibiotic Eagle Level citalopram hydrobromide (CELEXA) Depression 24 months Eagle Level; decline CITRACAL MAXIMUM Dietary supplement Eagle Level CLARINEX Cough/cold/allergies Eagle Level CLEMASTINE FUMARATE Antihistamine Eagle Level CLENIA FOAMING WASH Dermatological treatment Eagle Level CLEOCIN (clindamycin HCl) Antibiotic Eagle Level clindamycin HCl (CLEOCIN) Antibiotic Eagle Level CLINDAMYCIN PHOSPHATE Dermatological treatment Eagle Level CLINDESSE Bacterial vaginosis Eagle Level CLOBETASOL PROPIONATE Dermatological treatment Eagle Level CLODERM Dermatological treatment Eagle Level CLOMID (clomiphene citrate) Hormonal treatment Eagle Level clomiphene citrate (CLOMID) Hormonal treatment Eagle Level clomipramine HCl (ANAFRANIL) Obsessive compulsive disorder Eagle Level clonazepam (KLONOPIN) Seizures Eagle Level clonazepam (KLONOPIN) Panic disorder 24 months Eagle Level; decline clonidine/chlorthalidone (CLORPRESS) Hypertension Eagle Level

28 Drug Name clonidine HCl (CATAPRES) Hypertension Eagle Level clopidogrel (PLAVIX) Heart attack 12 months clopidogrel (PLAVIX) Stroke 12 months clorazepate dipotassium (TRANXENE) Anxiety disorder Eagle Level clorazepate dipotassium (TRANXENE) Seizures Eagle Level clorazepate dipotassium (TRANXENE) Alcohol withdrawal 24 months CLORPRESS (clonidine/chlorthalidone) Hypertension Eagle Level clotrimazole (MYCELEX) Fungal infection Eagle Level CODAL-DH Cough/cold/allergies Eagle Level COGENTIN (benztropine mesylate) Parkinson s disease Eagle Level colchicine (COLCRYS) Gout Eagle Level COLCRYS (colchicine) Gout Eagle Level colesevelam (WELCHOL) Elevated cholesterol Eagle Level colesevelam (WELCHOL) Diabetes Eagle Level (with no diabetic complications) COLESTID (colestipol) Elevated cholesterol Eagle Level colestipol (COLESTID) Elevated cholesterol Eagle Level COMBIGAN Glaucoma Eagle Level COMBIVENT (albuterol/ipratropium) Chronic obstructive pulmonary disease (COPD) COMBIVIR (lamivudine/zidovudine) HIV/AIDS COMPRO (prochlorperazine) Nausea/vomiting Eagle Level COMTAN (entacapone) Parkinson s disease Eagle Level CONCERTA (methylphenidate hydrochloride) ADHD Eagle Level CONDYLOX Dermatological treatment Eagle Level COPAXONE (glatiramer) Multiple sclerosis Eagle Level COPEGUS (ribavirin) Hepatitis C 24 months CORDARONE (amiodarone) Heart arrhythmia Eagle Level COREG (carvedilol) Hypertension Eagle Level COREG (carvedilol) Congestive heart failure CORGARD (nadolol) Hypertension Eagle Level CORGARD (nadolol) Angina 12 months CORICIDIN HBP FLU Cough/cold/allergies Eagle Level CORZIDE (nadolol/bendroflumethiazide) Hypertension Eagle Level COSOPT Glaucoma Eagle Level COUMADIN (warfarin) Clot prevention after heart valve placement 12 months COUMADIN (warfarin) Atrial fibrillation Eagle Level COVERA-HS (verapamil) Hypertension Eagle Level COVERA-HS (verapamil) Angina 12 months Eagle Level COVERA-HS (verapamil) Arrhythmia Eagle Level COZAAR (losartan) Hypertension Eagle Level COZAAR (losartan) Diabetic Kidney Disease 24 months p. 11

29 Prescription Drug Guide p. 12 Drug Name CREON (pancrelipase) Pancreatic enzyme - cystic fibrosis CREON (pancrelipase) Pancreatic enzyme - chronic pancreatitis 12 months Eagle Level; decline CREON (pancrelipase) Pancreatic enzyme - pancreatectomy 12 months Eagle Level; decline CRESTOR (rosuvastatin) Elevated cholesterol Eagle Level CRESYLATE External ear infection Eagle Level CROMOLYN SODIUM Allergies Eagle Level CUBICIN Skin infections Eagle Level CYANOCOBALAMIN Vitamin supplement Eagle Level cyclobenzaprine (FLEXERIL) Muscle relaxant Eagle Level CYCLOPENTOLATE HCL Eye drops Eagle Level cyclophosphamide (CYTOXAN) Cancer 24 months cyclophosphamide (CYTOXAN) Nephrotic syndrome (kidney disease) cyclophosphamide (CYTOXAN) Juvenile rheumatoid arthritis vasculitis Eagle Level cyclosporine (GENGRAF) Organ transplant rejection prevention CYMBALTA (duloxetine) Depression/anxiety 24 months Eagle Level; decline CYMBALTA (duloxetine) Fibromyalgia/musculoskeletal pain Eagle Level CYMBALTA (duloxetine) Diabetic peripheral neuropathy pain 24 months CYPROHEPTADINE HCL Antihistamine Eagle Level CYTOMEL (liothyronine) Thyroid replacement Eagle Level CYTOTEC (misoprostol) Ulcer Eagle Level CYTOXAN (cyclophosphamide) Cancer 24 months CYTOXAN (cyclophosphamide) Nephrotic syndrome (kidney disease) CYTOXAN (cyclophosphamide) Juvenile rheumatoid arthritis vasculitis Eagle Level CYTRA K CRYSTALS Urinary treatment/prevention of gout/kidney stones Eagle Level DALMANE (flurazepam) Insomnia Eagle Level DAPSONE Leprosy/skin infections Eagle Level DARVON (propoxyphene) Pain relief - narcotic Eagle Level DEMADEX (torsemide) Hypertension Eagle Level DEMADEX (torsemide) Liver disease DEMADEX (torsemide) Congestive heart failure DEMADEX (torsemide) Kidney disease DEMSER (metyrosine) Pheochromocytomas Eagle Level DEPAKOTE (divalproex sodium) Bipolar 24 months Eagle Level; decline DEPAKOTE (divalproex sodium) Epilepsy Eagle Level DEPAKOTE (divalproex sodium) Migraine Eagle Level DEPLIN Depression Eagle Level DEPO-MEDROL Multiple indications - corticosteroid Eagle Level DERMATOP Dermatological treatment Eagle Level DERMOTIC Ear drops Eagle Level

30 Drug Name desipramine HCl (NORPRAMIN) Depression Eagle Level DESMOPRESSIN ACETATE Hormonal treatment Eagle Level DESONIDE Dermatological treatment Eagle Level DESOXIMETASONE Dermatological treatment Eagle Level DESYREL (trazodone) Depression Eagle Level DETROL LA Urinary antispasmodic Eagle Level DEXAMETHASONE Multiple indications - corticosteroid Eagle Level DEXAPHEN SA Cough/cold/allergies Eagle Level DEXEDRINE (dextroamphetamine) Narcolepsy Eagle Level DEXEDRINE (dextroamphetamine) ADHD Eagle Level dexmethylphenidate HCL (FOCALIN) ADHD/narcolepsy/obesity Eagle Level dextroamphetamine (DEXEDRINE) Narcolepsy Eagle Level dextroamphetamine (DEXEDRINE) ADHD Eagle Level dextroamphetamine/amphetamine (ADDERALL) ADHD/narcolepsy Eagle Level DIABETA (glyburide) Diabetes Eagle Level (with no diabetic complications) DIAMOX (acetazolamide) Congestive heart failure DIAMOX (acetazolamide) Seizures Eagle Level DIAMOX (acetazolamide) Mountain sickness Eagle Level DIAMOX (acetazolamide) Glaucoma Eagle Level diazepam (VALIUM) Anxiety disorder Eagle Level diazepam (VALIUM) Convulsive disorder/muscle spasms Eagle Level diazepam (VALIUM) Alcohol withdrawal 24 months DIBENZYLINE Pheochromocytoma Eagle Level diclofenac (CATAFLAM) Pain relief - anti-inflammatory Eagle Level DICLOXACILLIN SODIUM Antibiotic Eagle Level dicyclomine (BENTYL) Irritable bowel syndrome Eagle Level diethylpropion (TENUATE) Obesity Eagle Level DIFFERIN Dermatological treatment Eagle Level DIFLORASONE DIACETATE Dermatological treatment Eagle Level diflunisal (DOLOBID) Pain relief - nonnarcotic Eagle Level DIGITEK (digoxin) Heart failure digoxin (DIGITEK, LANOXICAPS, LANOXIN, CAR- DOXIN) Heart failure DILACOR (diltiazem) Hypertension Eagle Level DILACOR (diltiazem) Angina 12 months DILANTIN (phenytoin) Seizures Eagle Level diltiazem (CARTIA XT, CARDIZEM, DILACOR, TIAZAC) Hypertension Eagle Level diltiazem (CARTIA XT, CARDIZEM, DILACOR, TIAZAC) Angina 12 months DIOVAN (valsartan) Hypertension Eagle Level DIOVAN (valsartan) Congestive heart failure DIOVAN (valsartan) Treatment after heart attack 12 months DIOVAN HCT (hydrochlorothiazide/valsartan) Hypertension Eagle Level DIPHENHYDRAMINE HCL Antihistamine Eagle Level p. 13

31 Prescription Drug Guide p. 14 Drug Name DIPHENOXYLATE/ATROPINE Diarrhea Eagle Level dipyridamole (PERSANTINE) Clot prevention after valve replacement 12 months DITROPAN XL Urinary spasm Eagle Level divalproex sodium (DEPAKOTE) Bipolar 24 months Eagle Level; decline divalproex sodium (DEPAKOTE) Epilepsy Eagle Level divalproex sodium (DEPAKOTE) Migraine Eagle Level docetaxel (TAXOTERE) Cancer 24 months DOC-Q-LACE Constipation Eagle Level DOCUSATE CALCIUM Constipation Eagle Level dofetilide (TIKOSYN) Heart arrhythmia Eagle Level DOLOBID (diflunisal) Pain relief - nonnarcotic Eagle Level DOMEBORO (acetic acid/aluminum acetate) External ear infection Eagle Level DOMPERIDONE BP Parkinson s disease Eagle Level DOMPERIDONE BP Nausea/vomiting Eagle Level DONATUSSIN Cough/cold/allergies Eagle Level donepezil (ARICEPT) Alzheimer s disease DOVONEX Dermatological treatment Eagle Level doxazosin mesylate (CARDURA) Benign prostatic hypertrophy Eagle Level doxazosin mesylate (CARDURA) Hypertension Eagle Level doxepin HCl (SINEQUAN) Depression/anxiety Eagle Level doxercalciferol (HECTOROL) Parathyroidism due to chronic kidney disease DOXYCYCLINE Antibiotic Eagle Level dronabinol (MARINOL) dronabinol (MARINOL) Appetitive stimulant in patients with AIDS Nausea and vomiting related to chemotherapy 24 months DUAC Dermatological treatment Eagle Level DUET DHA Vitamin supplement Eagle Level DUETACT (glimepiride/pioglitazone) Diabetes Eagle Level (with no diabetic complications) duloxetine (CYMBALTA) Depression/anxiety 24 months Eagle Level; decline duloxetine (CYMBALTA) Fibromyalgia/musculoskeletal pain Eagle Level duloxetine (CYMBALTA) Diabetic peripheral neuropathy pain 24 months DUONEB (albuterol/ipratropium) Chronic obstructive pulmonary disease (COPD) DURAFLU Cough/cold/allergies Eagle Level DURAGESIC (fentl) patch Continuous, persistent moderate to severe chronic pain Eagle Level DURAGESIC (fentl) patch Cancer pain 24 months DURAHIST D Cough/cold/allergies Eagle Level DURAPHEN FORTE Cough/cold/allergies Eagle Level DUREZOL Eye drops Eagle Level dutasteride (AVODART) Benign prostatic hypertrophy Eagle Level DYAZIDE (triamterene/hydrochlorothiazide) Hypertension Eagle Level

32 Drug Name DYAZIDE (triamterene/hydrochlorothiazide) Edema Eagle Level DYNA HIST ER (chlorpheniramine/ pseudoephedrine CR) Cold/cough/allergies Eagle Level DYNACIRC-CR (isradipine) Hypertension Eagle Level dyphylline/guaifenesin (DYPHYLLINE-GG) Asthma Eagle Level dyphylline/guaifenesin (DYPHYLLINE-GG) Emphysema/chronic bronchitis DYPHYLLINE-GG (dyphylline/guaifenesin) Asthma Eagle Level DYPHYLLINE-GG (dyphylline/guaifenesin) Emphysema/chronic bronchitis ECONAZOLE NITRATE Dermatological treatment Eagle Level ED A-HIST Cough/cold/allergies Eagle Level efavirenz (SUSTIVA) HIV/AIDS EFFEXOR (venlafaxine) Depression/anxiety Eagle Level ELDEPRYL (selegiline) Parkinson s disease Eagle Level ELESTAT Eye drops Eagle Level ELIDEL Dermatological treatment Eagle Level ELMIRON Bladder pain Eagle Level EMEND (aprepitant) EMEND (aprepitant) Nausea/vomiting prevention pre-surgery Nausea/vomiting prevention pre-chemotherapy Eagle Level 24 months emtricitabine/tenofovir (TRUVADA) HIV/AIDS ENABLEX Urinary spasm Eagle Level enalapril (VASOTEC) Hypertension Eagle Level enalapril (VASOTEC) Congestive heart failure enalapril/hydrochlorothiazide (VASERETIC) Hypertension Eagle Level ENBREL (etanercept) Rheumatoid arthritis/psoriatic arthritis/ankylosing spondylitis Eagle Level ENCORA Vitamin supplement Eagle Level ENDOMETRIN Hormonal treatment Eagle Level ENDURON (methyclothiazide) Hypertension Eagle Level ENDURON (methyclothiazide) Edema due to hormone or steroid therapy Eagle Level ENDURON (methyclothiazide) Liver cirrhosis ENDURON (methyclothiazide) Congestive heart failure enoxaparin (LOVENOX) Deep vein thrombosis (clot) Eagle Level enoxaparin (LOVENOX) Unstable angina 12 months enoxaparin (LOVENOX) Heart attack 12 months entacapone (COMTAN) Parkinson s disease Eagle Level entecavir (BARACLUDE) Hepatitis B 24 months ENTOCORT EC Crohn s disease Eagle Level ENULOSE Constipation Eagle Level EPICREAM Dermatological treatment Eagle Level EPINEPHRINE HCL Asthma Eagle Level EPIPEN Allergic reaction Eagle Level Eagle Level (if diagnosed as chronic Eagle Guaranteed) p. 15

33 Prescription Drug Guide p. 16 Drug Name EPIVIR (lamivudine) HIV/AIDS eplerenone (INSPRA) Hypertension Eagle Level eplerenone (INSPRA) Congestive heart failure epoetin alfa (PROCRIT) Cancer-related anemia 24 months epoetin alfa (PROCRIT) HIV-related anemia epoetin alfa (PROCRIT) Kidney disease-related anemia EPZICOM (abacavir/lamivudine) HIV/AIDS ERTACZO Dermatological treatment Eagle Level ERY-TAB Antibiotic Eagle Level ERYTHROCIN STEARATE Antibiotic Eagle Level escitalopram (LEXAPRO) Depression/anxiety 24 months Eagle Level; decline esomeprazole (NEXIUM) GERD/ulcers Eagle Level ESTAZOLAM Insomnia Eagle Level ESTRADIOL Hormonal treatment Eagle Level estradiol/norethindrone (ACTIVELLA) Menopausal symptoms Eagle Level ESTRATEST H.S. Hormonal treatment Eagle Level ESTRIOL Hormonal treatment Eagle Level ESTROPIPATE Hormonal treatment Eagle Level eszopiclone (LUNESTA) Insomnia Eagle Level etanercept (ENBREL) Rheumatoid arthritis/psoriatic arthritis/ankylosing spondylitis Eagle Level ETODOLAC Pain relief - anti-inflammatory Eagle Level etravirine (INTELENCE) HIV/AIDS EVISTA (raloxifene) Osteoporosis Eagle Level EVOXAC Dry mouth due to Sjögren s syndrome Eagle Level EXELDERM Dermatological treatment Eagle Level EXELON (rivastigmine transdermal) Alzheimer s disease/dementia exemestane (AROMASIN) Cancer 24 months exenatide (BYETTA) Diabetes Eagle Level (with no diabetic complications) EXFORGE (amlodipine/valsartan) Hypertension Eagle Level ezetimibe (ZETIA) Elevated cholesterol Eagle Level FACTIVE Antibiotic Eagle Level famciclovir (FAMVIR) Cold sores/shingles/herpes Eagle Level famciclovir (FAMVIR) Herpes in HIV-infected patients FAMOTIDINE Heartburn Eagle Level FAMVIR (famciclovir) Cold sores/shingles/herpes Eagle Level FAMVIR (famciclovir) Herpes in HIV-infected patients felbamate (FELBATOL) Epilepsy Eagle Level FELBATOL (felbamate) Epilepsy Eagle Level felodipine (PLENDIL) Hypertension Eagle Level FEMARA (letrozole) Breast cancer/cancer remission maintenance 24 months FEMHRT 1/5 Hormonal treatment Eagle Level

34 Drug Name fenofibrate (ANTARA) Elevated cholesterol/triglycerides Eagle Level fenofibrate (TRICOR) Elevated cholesterol/triglycerides Eagle Level FENOPROFEN CALCIUM Pain relief - anti-inflammatory Eagle Level fentl citrate (ACTIQ lozenge, ABSTRAL sublingual tablets, DURAGESIC patch, FENTORA tablet, IONSYS (inpatient hospital use only), LAZANDA nasal spray, ONSOLIS buccal soluble film, SUBSYS sublingual spray) fentl citrate (ACTIQ lozenge, ABSTRAL sublingual tablets, DURAGESIC patch, FENTORA tablet, IONSYS (inpatient hospital use only), LAZANDA nasal spray, ONSOLIS buccal soluble film, SUBSYS sublingual spray) Continuous, persistent moderate to severe chronic pain Eagle Level Cancer pain 24 months FENTORA (fentl) tablet Cancer pain 24 months FERRALET 90 Iron supplementation Eagle Level FERREX 150 FORTE Iron supplementation Eagle Level FERROGELS FORTE Iron supplementation Eagle Level FERROUS FUMARATE 324 Iron supplementation Eagle Level FERROUS GLUCONATE Iron supplementation Eagle Level FERROUS SULFATE Iron supplementation Eagle Level FEXOFENADINE HCL Antihistamine Eagle Level filgrastim (NEUPOGEN) Cancer 24 months FINACEA Dermatological treatment Eagle Level finasteride (PROPECIA, PROSCAR) Benign prostatic hypertrophy/male pattern baldness Eagle Level FLAREX Eye drops Eagle Level FLAVOXATE HCL Urinary spasm Eagle Level flecainide (TAMBOCOR) Heart arrhythmia Eagle Level FLECTOR Dermatological treatment Eagle Level FLEXERIL (cyclobenzaprine) Muscle relaxant Eagle Level FLEXTRA-650 Pain relief - nonnarcotic Eagle Level FLOMAX (tamsulosin) Benign prostatic hypertrophy Eagle Level FLORICAL Calcium supplement Eagle Level FLOVENT (fluticasone) Asthma Eagle Level FLOXIN OTIC Ear infection Eagle Level FLUCONAZOLE Fungal infection Eagle Level FLUDROCORTISONE ACETATE Addison s disease Eagle Level flumazenil (ROMAZICON) Drug overdose management 24 months flunisolide (AEROBID) Asthma Eagle Level FLUOCINONIDE Dermatological treatment Eagle Level FLUOCINONIDE-E Dermatological treatment Eagle Level FLUOROMETHOLONE Eye drops Eagle Level fluoxetine (PROZAC) Depression/OCD/panic disorder 24 months Eagle Level; decline fluoxetine/olanzapine (SYMBYAX) Depression/bipolar disorder 24 months Eagle Level; decline fluphenazine (PROLIXIN) Schizophrenia/psychotic disorder 24 months Eagle Level; decline flurazepam (DALMANE) Insomnia Eagle Level p. 17

35 Prescription Drug Guide p. 18 Drug Name FLURBIPROFEN SODIUM drops Eye drops Eagle Level FLURBIPROFEN tablet Rheumatoid arthritis/osteoarthritis Eagle Level fluticasone (FLOVENT) Asthma Eagle Level fluticasone propionate Allergies Eagle Level fluticasone propionate/salmeterol (ADVAIR DISKUS) Chronic obstructive pulmonary disease (COPD) fluticasone propionate/salmeterol (ADVAIR DISKUS) Asthma Eagle Level fluvastatin (LESCOL) Elevated cholesterol Eagle Level fluvoxamine (LUVOX) Obsessive compulsive disorder Eagle Level FOCALIN (dexmethylphenidate HCl) ADHD/narcolepsy/obesity Eagle Level FOLBEE Iron supplementation Eagle Level FOLBIC Vitamin supplement Eagle Level FOLGARD OS Vitamin supplement Eagle Level FOLITAB Vitamin supplement Eagle Level FOLTRIN Vitamin supplement Eagle Level fondaparinux sodium (ARIXTRA) Presurgical prevention of blood clot Eagle Level fondaparinux sodium (ARIXTRA) Treatment of blood clot Eagle Level fondaparinux sodium (ARIXTRA) reatment of pulmonary embolism (clot) FORADIL AEROLIZER (formoterol) Asthma Eagle Level FORADIL AEROLIZER (formoterol) Chronic obstructive pulmonary disease (COPD)/emphysema/ chronic bronchitis FORFIVO (bupropion) Depression Eagle Level formoterol (FORADIL AEROLIZER) Asthma Eagle Level formoterol (FORADIL AEROLIZER) Chronic obstructive pulmonary disease (COPD)/emphysema/ chronic bronchitis FORTAMET (metformin) Diabetes Eagle Level (with no diabetic complications) FORTEO Osteoporosis Eagle Level FOSAMAX Osteoporosis Eagle Level fosinopril (MONOPRIL) Hypertension Eagle Level fosinopril (MONOPRIL) Congestive heart failure fosinopril/hydrochlorothiazide (MONOPRIL HCT) Hypertension Eagle Level FOSRENOL (lanthanum carbonate) Kidney disease FRESHKOTE Eye drops Eagle Level FROVA Migraine Eagle Level furosemide (LASIX) Hypertension Eagle Level furosemide (LASIX) Congestive heart failure furosemide (LASIX) Kidney disease furosemide (LASIX) Liver disease gabapentin (NEURONTIN) Diabetic peripheral neuropathy pain 24 months gabapentin (NEURONTIN) Epilepsy Eagle Level GABITRIL (tiagabine) Seizures Eagle Level galantamine (RAZADYNE) Alzheimer s disease

36 Drug Name GAMMAGARD LIQUID Primary immunodeficiency GEMFIBROZIL Elevated triglycerides Eagle Level GENGRAF (cyclosporine) Transplant rejection GENTAMICIN SULFATE Antibiotic Eagle Level GEODON (ziprasidone) Schizophrenia/bipolar disorder 24 months Eagle Level; decline glatiramer (COPAXONE) Multiple sclerosis Eagle Level glimepiride (AMARYL) Diabetes Eagle Level (with no diabetic complications) glimepiride/pioglitazone (DUETACT) Diabetes Eagle Level (with no diabetic complications) glimepiride/rosiglitazone (AVANDARYL) Diabetes Eagle Level (with no diabetic complications) glipizide (GLUCOTROL) Diabetes Eagle Level (with no diabetic complications) glipizide/metformin (METAGLIP) Diabetes Eagle Level (with no diabetic complications) GLUCAGEN Diabetes - Hypoglycemia treatment Eagle Level (with no diabetic complications) GLUCOPHAGE (metformin) Diabetes Eagle Level (with no diabetic complications) GLUCOTROL (glipizide) Diabetes Eagle Level (with no diabetic complications) GLUCOVANCE (glyburide/metformin) Diabetes Eagle Level (with no diabetic complications) GLUMETZA (metformin) Diabetes Eagle Level (with no diabetic complications) glyburide (DIABETA, MICRONASE) Diabetes Eagle Level (with no diabetic complications) glyburide/metformin (GLUCOVANCE) Diabetes Eagle Level (with no diabetic complications) GLYCOLAX Constipation Eagle Level glycopyrrolate (ROBINUL) Ulcers Eagle Level GLYSET (miglitol) Diabetes Eagle Level (with no diabetic complications) golimumab (SIMPONI) Rheumatoid arthritis/psoriatic arthritis Eagle Level golimumab (SIMPONI) Ankylosing spondylitis Eagle Level granisetron (KYTRIL) Nausea and vomiting, postoperative Eagle Level granisetron (KYTRIL) Nausea and vomiting, pre-chemotherapy 24 months GRIFULVIN V Antifungal Eagle Level GRIS-PEG Antifungal Eagle Level GUAIFENEX DM Cough/cold/allergies Eagle Level guanfacine (INTUNIV, TENEX) Hypertension Eagle Level GUIADEX DM Cough/cold/allergies Eagle Level HALCION (triazolam) Insomnia Eagle Level HALDOL (haloperidol) Schizophrenia/psychosis 24 months Eagle Level; decline HALDOL (haloperidol) Tourette s disorder Eagle Level HALOBETASOL PROPIONATE Dermatological treatment Eagle Level haloperidol (HALDOL) Schizophrenia/psychosis 24 months Eagle Level; decline haloperidol (HALDOL) Tourette s disorder Eagle Level HECTOROL (doxercalciferol) Parathyroidism due to chronic kidney disease HELIDAC Ulcers Eagle Level HEMATINIC Vitamin supplement Eagle Level HEMAX Vitamin supplement Eagle Level p. 19

37 Prescription Drug Guide p. 20 Drug Name HEPSERA (adefovir) Hepatitis B 24 months HISTA-VENT DA Cough/cold/allergies Eagle Level HISTINEX HC Cough/cold/allergies Eagle Level Eagle Level (if diagnosed as chronic Eagle Guaranteed) HUMALOG (insulin) Diabetes Eagle Level (with no diabetic complications) HUMIRA (adalimumab) Rheumatoid arthritis/juvenile psoriatic arthritis Eagle Level HUMIRA (adalimumab) Crohn s disease Eagle Level HUMIRA (adalimumab) Ankylosing spondylitis Eagle Level HUMIRA (adalimumab) Plaque psoriasis Eagle Level HUMULIN (insulin) Diabetes Eagle Level (with no diabetic complications) HYALGAN Osteoarthritis Eagle Level HYDONE (chlorthalidone) Hypertension Eagle Level HYDONE (chlorthalidone) Congestive heart failure HYDONE (chlorthalidone) Liver cirrhosis HYDONE (chlorthalidone) Edema related to estrogen therapy Eagle Level hydralazine (APRESOLINE) Hypertension Eagle Level HYDREA (hydroxyurea) Cancer 24 months HYDREA (hydroxyurea) Essential thrombocytopenia Eagle Level hydrochlorothiazide Hypertension Eagle Level hydrochlorothiazide/losartan (HYZAAR) Hypertension Eagle Level hydrochlorothiazide/losartan (HYZAAR) Left ventricular hypertrophy 12 months hydrochlorothiazide/moexipril (UNIRETIC) Hypertension Eagle Level hydrochlorothiazide/spironolactone (ALDACTAZIDE) Hypertension Eagle Level hydrochlorothiazide/spironolactone (ALDACTAZIDE) Liver cirrhosis hydrochlorothiazide/spironolactone (ALDACTAZIDE) Congestive heart failure hydrochlorothiazide/spironolactone (ALDACTAZIDE) Kidney disease hydrochlorothiazide/telmisartan (MICARDIS) Hypertension Eagle Level hydrochlorothiazide/valsartan (DIOVAN HCT) Hypertension Eagle Level HYDROCODONE BITARTRATE Cough/cold/allergies Eagle Level HYDROCODONE/ACETAMINOPHEN Pain relief - narcotic Eagle Level HYDROCODONE/GUAIFENESIN Cough syrup Eagle Level HYDROCODONE/HOMATROPINE Cough syrup Eagle Level HYDROCODONE/IBUPROFEN Pain relief - narcotic Eagle Level HYDROCORTISONE Dermatological treatment Eagle Level HYDRO-DP Cough/cold/allergies Eagle Level HYDROMORPHONE HCL Pain relief - narcotic Eagle Level HYDRON PSC Cough/cold/allergies Eagle Level HYDROQUINONE Dermatological treatment Eagle Level HYDRO-TUSSIN Cough syrup Eagle Level HYDROXYCHLOROQUINE SULFATE Malaria Eagle Level hydroxyurea (HYDREA) Cancer 24 months hydroxyurea (HYDREA) Essential thrombocytopenia Eagle Level

38 Drug Name HYDROXYZINE HCL Anxiety Eagle Level HYDROXYZINE HCL Itching due to allergies Eagle Level HYGROTON (chlorthalidone) Hypertension Eagle Level HYGROTON (chlorthalidone) Congestive heart failure HYGROTON (chlorthalidone) Liver cirrhosis HYGROTON (chlorthalidone) Edema related to estrogen therapy Eagle Level HYOSCYAMINE SULFATE ER Ulcers Eagle Level HYTRIN (terazosin) Benign prostatic hypertrophy Eagle Level HYZAAR (hydrochlorothiazide/losartan) Hypertension Eagle Level HYZAAR (hydrochlorothiazide/losartan) Left ventricular hypertrophy 12 months ibandronate (BONIVA) Osteoporosis Eagle Level imipramine (TOFRANIL) Depression 24 months Eagle Level; decline imiquimod (ALDARA) Dermatological treatment Eagle Level IMITREX (sumatriptan) Migraine Eagle Level IMURAN (azathioprine) Kidney transplant rejection prevention IMURAN (azathioprine) Rheumatoid arthritis Eagle Level indapamide (LOZOL) Hypertension Eagle Level indapamide (LOZOL) Congestive heart failure INDERAL (propranolol) Hypertension Eagle Level INDERAL (propranolol) Migraine Eagle Level INDERAL (propranolol) Angina 12 months INDERAL (propranolol) Hypertrophic subaortic stenosis (cardiomyopathy) INDOCIN (indomethacin) Rheumatoid arthritis Eagle Level indomethacin (INDOCIN) Rheumatoid arthritis Eagle Level INSPRA (eplerenone) Hypertension Eagle Level INSPRA (eplerenone) Congestive heart failure insulin glulisine (APIDRA) Diabetes Eagle Level (with no diabetic complications) INTELENCE (etravirine) HIV/AIDS interferon alfa-2b (INTRON) Cancer 24 months interferon alfa-2b (INTRON) Hepatitis C 24 months interferon alfa-2b (INTRON) AIDS-related Kaposi s sarcoma interferon alfa-2b (INTRON) Genital warts Eagle Level Interferon beta-1a (AVONEX, REBIF) Multiple sclerosis Eagle Level INTRON-A (interferon alfa-2b) Cancer 24 months INTRON-A (interferon alfa-2b) Hepatitis C 24 months INTRON-A (interferon alfa-2b) AIDS-related Kaposi s sarcoma INTRON-A (interferon alfa-2b) Genital warts Eagle Level INTUNIV (guanfacine) Hypertension Eagle Level INVEGA (paliperidone) Schizophrenia 24 months Eagle Level; decline IONSYS (fentl) HOSPITAL USE ONLY Continuous, persistent moderate to severe chronic pain Eagle Level p. 21

39 Prescription Drug Guide p. 22 Drug Name ipratropium bromide HFA (ATROVENT HFA) ipratropium bromide nasal spray (ATROVENT NASAL SPRAY) Chronic obstructive pulmonary disease (COPD)/emphysema Allergic and non-allergic nasal symptoms Eagle Level IQUIX Eye drops Eagle Level irbesartan (AVAPRO) Hypertension Eagle Level irbesartan (AVAPRO) Diabetic kidney disease irbesartan and hydrochlorothiazide (AVALIDE) Hypertension Eagle Level ISOMETHEPTENE/DICHLORALPHENAZONE/ ACET- AMINOPHEN Migraine Eagle Level isoniazid (NYDRAZID) Tuberculosis ISOPTIN (verapamil) Hypertension Eagle Level ISOPTIN (verapamil) Angina 12 months ISOPTIN (verapamil) Arrhythmia Eagle Level ISOPTO HOMATROPINE Eye drops Eagle Level ISORDIL (isosorbide) Angina 12 months isosorbide (ISORDIL) Angina 12 months isosorbide dinitrate and hydralazine hydrochloride (BIDIL) Congestive heart failure isradipine (DYNACIRC-CR) Hypertension Eagle Level JALYN Benign prostatic hypertrophy Eagle Level JANUMET (metformin/sitagliptin) Diabetes Eagle Level (with no diabetic complications) JANUVIA (sitagliptin) Diabetes Eagle Level (with no diabetic complications) KALETRA (lopinavir/ritonavir) HIV/AIDS KAPIDEX Esophagitis/heartburn/GERD Eagle Level KENALOG-40 Multiple indications - corticosteroid Eagle Level KEPPRA (levetiracetam) Epilepsy Eagle Level KEROL Dermatological treatment Eagle Level KETOCONAZOLE Fungal infection Eagle Level KETOPROFEN Pain relief - anti-inflammatory Eagle Level KETOROLAC TROMETHAMINE Seasonal allergic symptoms Eagle Level KLARON Dermatological treatment Eagle Level KLONOPIN (clonazepam) Seizures Eagle Level KLONOPIN (clonazepam) Panic disorder 24 months Eagle Level; decline KLOR-CON 10 Potassium supplementation Eagle Level KYTRIL (granisetron) Nausea and vomiting, postoperative Eagle Level KYTRIL (granisetron) Nausea and vomiting, pre-chemotherapy 24 months labetalol (NORMODYNE, TRANDATE) Hypertension Eagle Level LAC-HYDRIN (ammonium lactate) Dermatological treatment Eagle Level LACTULOSE Constipation Eagle Level LAMICTAL (lamotrigine) Epilepsy Eagle Level LAMICTAL (lamotrigine) Bipolar disorder 24 months Eagle Level; decline LAMISIL Fungal infection Eagle Level

40 Drug Name lamivudine (EPIVIR) HIV/AIDS lamivudine/zidovudine (COMBIVIR) HIV/AIDS lamotrigine (LAMICTAL) Epilepsy Eagle Level lamotrigine (LAMICTAL) Bipolar disorder 24 months Eagle Level; decline LANOXICAPS (digoxin) Heart failure LANOXIN (digoxin) Heart failure lansoprazole (PREVACID) Ulcers Eagle Level lanthanum carbonate (FOSRENOL) Kidney disease LANTUS (insulin) Diabetes Eagle Level (with no diabetic complications) LASIX (furosemide) Hypertension Eagle Level LASIX (furosemide) Congestive heart failure LASIX (furosemide) Kidney disease LASIX (furosemide) Liver disease LAZANDA (fentl) nasal spray Cancer pain 24 months leflunomide (ARAVA) Rheumatoid arthritis Eagle Level lenalidomide (REVLIMID) Cancer 24 months LESCOL (fluvastatin) Elevated cholesterol Eagle Level letrozole (FEMARA) Breast cancer/cancer remission maintenance 24 months LEUCOVORIN CALCIUM Cancer 24 months LEVAQUIN Antibiotic Eagle Level LEVEMIR FLEXPEN (insulin) Diabetes Eagle Level (with no diabetic complications) levetiracetam (KEPPRA) Epilepsy Eagle Level LEVITRA Erectile dysfunction Eagle Level LEVOBUNOLOL HCL Eye drops Eagle Level LEXAPRO (escitalopram) Depression/anxiety 24 months Eagle Level; decline LIBRAX (chlordiazepoxide/clidinium) Irritable bowel syndrome Eagle Level LIBRIUM (chlordiazepoxide HCl) Alcohol withdrawal 24 months LIDODERM Dermatological treatment Eagle Level LIMBITROL (chlordiazepoxide/amitriptyline) Depression/anxiety 24 months Eagle Level; decline LIMBREL Osteoarthritis Eagle Level LINCOCIN Antibiotic Eagle Level liothyronine (CYTOMEL) Thyroid replacement Eagle Level LIPITOR (atorvastatin) Elevated cholesterol Eagle Level LIQUITEARS Eye drops Eagle Level liraglutide (VICTOZA) Diabetes Eagle Level (with no diabetic complications) lisinopril (PRINIVIL, ZESTRIL) Hypertension Eagle Level lisinopril (PRINIVIL, ZESTRIL) Congestive heart failure lisinopril (PRINIVIL, ZESTRIL) Heart attack 12 months lisinopril/hydrochlorothiazide (PRINZIDE, ZESTORETIC) Hypertension Eagle Level LITHIUM CARBONATE Bipolar disorder Eagle Level; decline LOCOID LIPOCREAM Dermatological treatment Eagle Level p. 23

41 Prescription Drug Guide p. 24 Drug Name LODRANE 24D Cough/cold/allergies Eagle Level LOPERAMIDE HCL Diarrhea Eagle Level lopinavir/ritonavir (KALETRA) HIV/AIDS LOPRESSOR (metoprolol) Hypertension Eagle Level LOPRESSOR (metoprolol) Angina 12 months LOPRESSOR (metoprolol) Congestive heart failure LORATADINE Antihistamine Eagle Level lorazepam (ATIVAN) Anxiety Eagle Level losartan (COZAAR) Hypertension Eagle Level losartan (COZAAR) Diabetic Kidney Disease 24 months LOTEMAX Eye drops Eagle Level LOTENSIN (benazepril HCl) Hypertension Eagle Level LOTREL (amlodipine/benazepril) Hypertension Eagle Level LOTRONEX Irritable bowel syndrome Eagle Level lovastatin (ALTOPREV, MEVACOR, ALTOCOR) Elevated cholesterol Eagle Level LOVAZA (omega-3-acid ethyl esters) Elevated triglycerides Eagle Level LOVENOX (enoxaparin) Deep vein thrombosis (clot) Eagle Level LOVENOX (enoxaparin) Unstable angina 12 months LOVENOX (enoxaparin) Heart attack 12 months LOXAPINE SUCCINATE Schizophrenia 24 months Eagle Level; decline LOZOL (indapamide) Hypertension Eagle Level LOZOL (indapamide) Congestive heart failure lubiprostone (AMITIZA) Constipation Eagle Level LUMIGAN Eye drops Eagle Level LUNESTA (eszopiclone) Insomnia Eagle Level LUPRON DEPOT Cancer 24 months LUVOX (fluvoxamine) Obsessive compulsive disorder Eagle Level LUXIQ Dermatological treatment Eagle Level LYRICA (pregabalin) Neuropathic pain - diabetic/ postherpetic 24 months LYRICA (pregabalin) Seizures Eagle Level LYRICA (pregabalin) Fibromyalgia Eagle Level MAGNESIUM SULFATE Convulsion Eagle Level MAGNESIUM SULFATE Magnesium deficiency Eagle Level MALARONE Malaria Eagle Level MAPAP Pain relief - nonnarcotic Eagle Level MAPAP PM Insomnia Eagle Level MAPAP SINUS MAXIMUM STRENGTH Cough/cold/allergies Eagle Level MARINOL (dronabinol) MARINOL (dronabinol) Appetite stimulant in patients with AIDS Nausea and vomiting related to chemotherapy 24 months MARPLAN Depression Eagle Level MAVIK (trandolapril) Hypertension Eagle Level

42 Drug Name MAVIK (trandolapril) Congestive heart failure MAXAIR AUTOHALER (pirbuterol inhaler) Asthma Eagle Level MAXALT Migraine Eagle Level MAXARON FORTE Iron supplementation Eagle Level MAXIDEX Eye drops Eagle Level MAXZIDE (triamterene/hydrochlorothiazide) Hypertension Eagle Level MAXZIDE (triamterene/hydrochlorothiazide) Edema Eagle Level MEBENDAZOLE Worm infection Eagle Level MECLIZINE HCL Nausea Eagle Level MEFLOQUINE HCL Malaria Eagle Level MEGACE ES (megestrol) liquid Appetite stimulant in patients with AIDS MEGACE ES (megestrol) liquid Cancer-related weight loss 24 months MEGACE ES (megestrol) tablets megestrol (MEGACE) liquid Breast or uterine cancer palliative therapy Appetite stimulant in patients with AIDS 24 months megestrol (MEGACE) liquid Cancer-related weight loss 24 months megestrol (MEGACE) tablets Breast or uterine cancer palliative therapy 24 months memantine (NAMENDA) Alzheimer s disease MENEST (esterified estrogen) Menopausal symptoms Eagle Level MENEST (esterified estrogen) Breast and prostatic cancer 24 months MENTAX Dermatological treatment Eagle Level MEPERIDINE HCL Moderate to severe pain - narcotic Eagle Level MEPHYTON Coagulation disorder Eagle Level MEPROZINE Moderate to severe pain - narcotic Eagle Level mercaptopurine (PURINETHOL) Cancer 24 months mesalamine (ASACOL) Ulcerative colitis Eagle Level mesalamine (ROWASA) Ulcerative colitis/proctitis Eagle Level METAGLIP (glipizide/metformin) Diabetes Eagle Level METANX Diabetic neuropathy 24 months metaproterenol sulfate (ALUPENT) Asthma Eagle Level metaproterenol sulfate (ALUPENT) Emphysema metformin (FORTAMET, GLUCOPHAGE, GLUMETZA, RIOMET) Diabetes Eagle Level (with no diabetic complications) metformin/pioglitazone (ACTOPLUS MET) Diabetes Eagle Level (with no diabetic complications) metformin/repaglinide (PRANDIMET) Diabetes Eagle Level (with no diabetic complications) metformin/rosiglitazone (AVANDAMET) Diabetes Eagle Level (with no diabetic complications) metformin/sitagliptin (JANUMET) Diabetes Eagle Level (with no diabetic complications) methadone HCl (DISKETS, DOLOPHINE, METHADOSE) methadone HCl (DISKETS, DOLOPHINE, METHADOSE) Moderate to severe pain - narcotic Eagle Level Opiate addiction 24 months METHAZOLAMIDE Glaucoma Eagle Level p. 25

43 Prescription Drug Guide p. 26 Drug Name METHENAMINE HIPPURATE Urinary tract infection Eagle Level METHERGINE Obstetric care Eagle Level METHIMAZOLE Thyroid Eagle Level methocarbamol (ROBAXIN) Muscle relaxer Eagle Level methotrexate (RHEUMATREX DOSE PACK, TREXALL) Rheumatoid arthritis Eagle Level methotrexate (RHEUMATREX DOSE PACK, TREXALL) Psoriasis, severe Eagle Level methotrexate (RHEUMATREX DOSE PACK, TREXALL) Cancer 24 months methsuximide (CELONTIN) Seizures Eagle Level methyclothiazide (ENDURON) Hypertension Eagle Level methyclothiazide (ENDURON) Edema due to hormone or steroid therapy Eagle Level methyclothiazide (ENDURON) Liver cirrhosis methyclothiazide (ENDURON) Congestive heart failure methyldopa (ALDOMET) Hypertension Eagle Level methylphenidate hydrochloride (CONCERTA) ADHD Eagle Level methylprednisolone Multiple indications - corticosteroid Eagle Level methyltestosterone (TESTRED) Males: hormonal treatment Eagle Level methyltestosterone (TESTRED) Females: Inoperable breast cancer 24 months METIPRANOLOL Eye drops Eagle Level metoclopramide HCl (REGLAN) GERD Eagle Level metoclopramide HCl (REGLAN) metoclopramide HCl (REGLAN) Diabetic gastroparesis (delayed digestion) Nausea and vomiting related to chemotherapy Eagle Level 24 months metolazone (ZAROXOLYN) Hypertension Eagle Level metolazone (ZAROXOLYN) Congestive heart failure metolazone (ZAROXOLYN) Kidney disease metoprolol (LOPRESSOR, TOPROL-XL) Hypertension Eagle Level metoprolol (LOPRESSOR, TOPROL-XL) Angina 12 months metoprolol (LOPRESSOR, TOPROL-XL) Congestive heart failure METROGEL Dermatological treatment Eagle Level METRONIDAZOLE Antibiotic Eagle Level metyrosine (DEMSER) Pheochromocytomas Eagle Level MEVACOR (lovastatin) Elevated cholesterol Eagle Level mexiletine (MEXITIL) Heart arrhythmia Eagle Level MEXITIL (mexiletine) Heart arrhythmia Eagle Level MIACALCIN (calcitonin) Osteoporosis Eagle Level MIACALCIN (calcitonin) Paget s bone disease Eagle Level MI-ACID Antacid Eagle Level MICARDIS (hydrochlorothiazide/telmisartan) Hypertension Eagle Level MICRONASE (glyburide) Diabetes Eagle Level (with no diabetic complications) MIDAMOR (amiloride HCl) Hypertension Eagle Level MIDAMOR (amiloride HCl) Congestive heart failure MIDODRINE HCL Low blood pressure Eagle Level

44 Drug Name miglitol (GLYSET) Diabetes Eagle Level (with no diabetic complications) MIGRANAL Migraine Eagle Level MIGRATEN Migraine Eagle Level milnacipran (SAVELLA) Fibromyalgia Eagle Level MIMYX Dermatological treatment Eagle Level MINIPRESS (prazosin) Hypertension Eagle Level MINOCYCLINE HCL Antibiotic Eagle Level MINOXIDIL Hypertension Eagle Level MINOXIDIL Hair regrowth treatment Eagle Level MINTOX PLUS Antacid Eagle Level MIRAPEX (pramipexole) Restless legs syndrome Eagle Level MIRAPEX (pramipexole) Parkinson s disease Eagle Level mirtazapine (REMERON) Depression Eagle Level misoprostol (CYTOTEC) Ulcers Eagle Level MOBIC Pain relief - anti-inflammatory Eagle Level MOBISYL Dermatological treatment Eagle Level modafinil (PROVIGIL) Narcolepsy (improves excessive sleepiness) Eagle Level moexipril (UNIVASC) Hypertension Eagle Level MOMETASONE FUROATE Dermatological treatment Eagle Level MONOPRIL (fosinopril) Hypertension Eagle Level MONOPRIL (fosinopril) Congestive heart failure MONOPRIL HCT (fosinopril/hydrochlorothiazide) Hypertension Eagle Level montelukast (SINGULAIR) Allergies/asthma Eagle Level morphine sulfate (AVINZA) Moderate to severe pain - narcotic Eagle Level MOVIPREP Constipation Eagle Level moxifloxacin (AVELOX) Antibiotic Eagle Level MST 600 Pain relief - nonnarcotic Eagle Level MUCOMYST (acetylcysteine) Emphysema MUCOMYST (acetylcysteine) Tuberculosis MUCOMYST (acetylcysteine) Pneumonia/bronchitis Eagle Level MUCOMYST (acetylcysteine) Cystic fibrosis MULTAQ Heart arrhythmia Eagle Level MULTIRET FOLIC-500 Vitamin supplement Eagle Level MUPIROCIN Dermatological treatment Eagle Level MYCELEX (clotrimazole) Fungal infection Eagle Level mycophenolate (CELLCEPT) Transplant rejection mycophenolic acid (MYFORTIC) Organ transplant rejection MYFORTIC (mycophenolic acid) Organ transplant rejection nabumetone (RELAFEN) Rheumatoid arthritis/osteoarthritis Eagle Level nadolol (CORGARD) Hypertension Eagle Level nadolol (CORGARD) Angina 12 months nadolol/bendroflumethiazide (CORZIDE) Hypertension Eagle Level p. 27

45 Prescription Drug Guide p. 28 Drug Name NAFCILLIN SODIUM Antibiotic Eagle Level NAFTIN Dermatological treatment Eagle Level NALDEX Cough/cold/allergies Eagle Level naloxone (NARCAN) Opiate overdose 24 months naltrexone (REVIA) Alcohol dependence 24 months naltrexone (VIVITROL) Alcohol dependence/opiate dependence 24 months NAMENDA (memantine) Alzheimer s disease NAPROXEN Pain relief - anti-inflammatory Eagle Level NARCAN (naloxone) Opiate overdose 24 months NASACORT AQ Allergy symptoms Eagle Level NASAREL Allergy symptoms Eagle Level NASONEX Allergy symptoms Eagle Level NATAFORT Vitamin supplement Eagle Level NATALCARE GLOSSTABS Vitamin supplement Eagle Level NATATAB RX Vitamin supplement Eagle Level nateglinide (STARLIX) Diabetes Eagle Level (with no diabetic complications) nebivolol (BYSTOLIC) Hypertension Eagle Level NEEVO DHA Vitamin supplement Eagle Level NEFAZODONE HCL Depression Eagle Level NEO AC Cough/cold/allergies Eagle Level NEOMYCIN/POLYMYXIN/BACITRACIN Eye drops Eagle Level NEOMYCIN/POLYMYXIN/DEXAMETHASONE Eye drops Eagle Level NEOMYCIN/POLYMYXIN/GRAMICIDIN Eye drops Eagle Level NEOMYCIN/POLYMYXIN/HYDROCORTISONE Eye drops Eagle Level NEOMYCIN SULFATE Topical antibiotic Eagle Level NERVO B-12 SL Vitamin supplement Eagle Level NEUPOGEN (filgrastim) Cancer 24 months NEURONTIN (gabapentin) Diabetic peripheral neuropathy pain 24 months NEURONTIN (gabapentin) Epilepsy Eagle Level NEUTRA-PHOS Mineral/electrolyte supplement Eagle Level NEVANAC Eye drops Eagle Level NEXAVAR (sorafenib) Cancer 24 months NEXIUM (esomeprazole) GERD/ulcers Eagle Level niacin (NIASPAN) Elevated cholesterol Eagle Level niacin/lovastatin (ADVICOR) Elevated cholesterol Eagle Level NIACOR Vitamin supplement/elevated cholesterol Eagle Level NIASPAN (niacin) Elevated cholesterol Eagle Level NICORETTE STARTER KIT Smoking cessation 12 months Smoker rates (Eagle Level) NICOTINE Smoking cessation 12 months Smoker rates (Eagle Level) NIFEDICAL (nifedipine) Hypertension Eagle Level nifedipine (ADALAT, PROCARDIA, NIFEDICAL, AFEDITAB) Hypertension Eagle Level

46 Drug Name NIFEREX Iron supplementation Eagle Level nisoldipine (Sular) Hypertension Eagle Level NITROFURANTOIN Urinary tract antibiotic Eagle Level nitroglycerine (NITRO-TIME, NITROLINGUAL, NITROMIST, NITROSTAT, NITROQUICK Angina 12 months NITROLINGUAL (nitroglycerin) Angina 12 months NITROMIST (nitroglycerin) Angina 12 months NITROQUICK (nitroglycerin) Angina 12 months NITROSTAT (nitroglycerin) Angina 12 months NITRO-TIME (nitroglycerin) Angina 12 months nizatidine (AXID) Ulcers/esophagitis Eagle Level NOHIST-EXT Antihistamine Eagle Level NOREL SR Cough/cold/allergies Eagle Level NORETHINDRONE ACETATE Hormonal treatment Eagle Level NORFLEX (orphenadrine) Muscle relaxer Eagle Level NORMODYNE (labetalol) Hypertension Eagle Level NOROXIN Antibiotic Eagle Level NORPRAMIN (desipramine HCl) Depression Eagle Level NORTRIPTYLINE HCL Depression Eagle Level NORVASC (amlodipine) Hypertension Eagle Level NORVASC (amlodipine) Coronary artery disease 12 months NORVIR (ritonavir) HIV/AIDS NOVACORT Dermatological treatment Eagle Level NOVOLOG (insulin) Diabetes Eagle Level (with no diabetic complications) NUCYNTA Moderate to severe pain - narcotic Eagle Level NUTROPIN AQ PEN Hormonal treatment Eagle Level NUVIGIL Narcolepsy (improves excessive sleepiness) Eagle Level NYDRAZID (isoniazid) Tuberculosis NYSTATIN Fungal infection Eagle Level NYSTATIN/TRIAMCINOLONE Dermatological treatment Eagle Level NYSTOP Dermatological treatment Eagle Level OFLOXACIN Eye drops Eagle Level olanzapine (ZYPREXA) Schizophrenia/bipolar disorder 24 months Eagle Level; decline olmesartan (BENICAR HCT) Hypertension Eagle Level OLUX-E Dermatological treatment Eagle Level omega-3-acid ethyl esters (LOVAZA) Elevated triglycerides Eagle Level omeprazole (PRILOSEC) Ulcers/GERD/esophagitis Eagle Level omeprazole/sodium bicarbonate (ZEGERID) Ulcers/GERD/esophagitis Eagle Level OMNARIS Allergies Eagle Level OMNICEF Antibiotic Eagle Level onabotulinumtoxina (BOTOX) Spasticity/multiple indications Eagle Level ondansetron (ZOFRAN) Nausea/vomiting related to chemotherapy 24 months p. 29

47 Prescription Drug Guide p. 30 Drug Name ONGLYZA (saxagliptin) Diabetes Eagle Level (with no diabetic complications) ONSOLIS (fentl) buccal soluble film Cancer pain 24 months OPANA ER Moderate to severe pain - narcotic Eagle Level OPTI-CLEAR Eye drops Eagle Level OPTIVAR Eye drops Eagle Level ORACEA Dermatological treatment Eagle Level ORAP Tourette s disorder Eagle Level orphenadrine (NORFLEX) Muscle relaxer Eagle Level OVIDE Dermatological treatment Eagle Level OXAPROZIN Pain relief - anti-inflammatory Eagle Level oxazepam (SERAX) Anxiety Eagle Level oxcarbazepine (TRILEPTAL) Seizures Eagle Level OXISTAT Dermatological treatment Eagle Level OXSORALEN ULTRA Psoriasis, severe Eagle Level OXYCODONE Moderate to severe pain - narcotic Eagle Level OXYTROL Urinary spasm Eagle Level OYSCO 500 Mineral/electrolyte supplement Eagle Level OYST-CAL Mineral/electrolyte supplement Eagle Level PACERONE (amiodarone) Heart arrhythmia Eagle Level paliperidone (INVEGA) Schizophrenia 24 months Eagle Level; decline pamidronate (AREDIA) Cancer 24 months pamidronate (AREDIA) Paget s bone disease Eagle Level PAMINE FORTE Ulcer Eagle Level pancrelipase (CREON) Pancreatic enzyme - cystic fibrosis pancrelipase (CREON) Pancreatic enzyme - chronic pancreatitis 12 months Eagle Level; decline pancrelipase (CREON) Pancreatic enzyme - pancreatectomy 12 months Eagle Level; decline PANLOR SS Moderate to severe pain - narcotic Eagle Level pantoprazole (PROTONIX) GERD/ulcers Eagle Level papain and urea (ACCUZYME) Dermatological treatment Eagle Level PARAFON FORTE DSC (chlorzoxazone) Musculoskeletal pain Eagle Level PAREGORIC Diarrhea Eagle Level paricalcitol (ZEMPLAR) Kidney disease paroxetine (PAXIL, PEXEVA) Depression/OCD/panic disorder 24 months Eagle Level; decline PATANASE Allergies Eagle Level PATANOL Eye drops Eagle Level PAXIL (paroxetine) Depression/OCD/panic disorder 24 months Eagle Level; decline PEDIOX-S Antihistamine Eagle Level PEGASYS (peginterferon alfa-2a) Hepatitis B and C 24 months PEG-INTRON Hepatitis C 24 months PENICILLIN V POTASSIUM Antibiotic Eagle Level PENLAC NAIL LACQUER Dermatological treatment Eagle Level PENTAZOCINE/ACETAMINOPHEN Pain relief - narcotic Eagle Level

48 Drug Name PENTAZOCINE/NALOXONE HCL Moderate to severe pain - narcotic Eagle Level pentoxifylline (PENTOXIL, TRENTAL) Circulation disorder Eagle Level PENTOXIL (pentoxifylline) Circulation disorder Eagle Level PERIDEX (chlorhexidine gluconate) Antiseptic rinse Eagle Level perindopril (ACEON) Hypertension Eagle Level perindopril (ACEON) Coronary artery disease 12 months PERMETHRIN Dermatological treatment Eagle Level PERPHENAZINE Schizophrenia 24 months Eagle Level; decline PERPHENAZINE Severe nausea/vomiting Eagle Level PERPHENAZINE/AMITRIPTYLINE Depression/anxiety Eagle Level PERSANTINE (dipyridamole) Clot prevention after valve replacement 12 months PEXEVA (paroxetine) Depression/OCD/panic disorder 24 months Eagle Level; decline PHENAVENT LA Cough/cold/allergies Eagle Level PHENAZOPYRIDINE HCL Urinary spasm Eagle Level PHENDIMETRAZINE TARTRATE Obesity Eagle Level PHENOBARBITAL Sedative/seizures Eagle Level PHENTERMINE HCL ADHD/narcolepsy/obesity Eagle Level phenytoin (DILANTIN) Seizures Eagle Level PHENYTOIN SODIUM EXTENDED Seizures Eagle Level P-HIST Cough/cold/allergies Eagle Level PHOSPHA 250 NEUTRAL Mineral/electrolyte supplement Eagle Level PILOCARPINE HCL (Ophthalmic) Eye drops Eagle Level PILOCARPINE HCL (Oral) Dry mouth Eagle Level PILOCARPINE HCL (Oral) Dry mouth due to cancer radiation treatment 24 months PINDOLOL Hypertension Eagle Level pioglitazone (ACTOS) Diabetes Eagle Level (with no diabetic complications) pirbuterol inhaler (MAXAIR AUTOHALER) Asthma Eagle Level PIROXICAM Pain relief - anti-inflammatory Eagle Level PLAVIX (clopidogrel) Heart attack 12 months PLAVIX (clopidogrel) Stroke 12 months PLENDIL (felodipine) Hypertension Eagle Level PLETAL (cilostazol) Circulatory disease Eagle Level POLY HIST FORTE Cough/cold/allergies Eagle Level POLYMYXIN B SULFATE/TRIMETHOPRIM SULFATE Eye drops Eagle Level pramipexole (MIRAPEX) Restless legs syndrome Eagle Level pramipexole (MIRAPEX) Parkinson s disease Eagle Level pramlintide (SYMLIN) Diabetes Eagle Level (with no diabetic complications) PRAMOSONE Dermatological treatment Eagle Level PRANDIMET (metformin/repaglinide) Diabetes Eagle Level (with no diabetic complications) PRANDIN (repaglinide) Diabetes Eagle Level (with no diabetic complications) PRAVACHOL (pravastatin) Elevated cholesterol Eagle Level p. 31

49 Prescription Drug Guide p. 32 Drug Name pravastatin (PRAVACHOL) Elevated cholesterol Eagle Level prazosin (MINIPRESS) Hypertension Eagle Level PRECOSE (acarbose) Diabetes Eagle Level (with no diabetic complications) PREDNISOLONE Multiple indications - corticosteroid Eagle Level PREDNISOLONE ACETATE Eye drops Eagle Level PREDNISONE Multiple indications - corticosteroid Eagle Level pregabalin (LYRICA) Neuropathic pain - diabetic/ postherpetic 24 months pregabalin (LYRICA) Seizures Eagle Level pregabalin (LYRICA) Fibromyalgia Eagle Level PREMARIN Hormonal treatment Eagle Level PREMPRO Hormonal treatment Eagle Level PRENATAL 19 Vitamin supplement Eagle Level PRENATAL PLUS Vitamin supplement Eagle Level PREVACID (lansoprazole) Ulcers Eagle Level PREVPAC Ulcers Eagle Level PRILOSEC (omeprazole) Ulcers/GERD/esophagitis Eagle Level PRIMACARE ONE Vitamin supplement Eagle Level PRIMIDONE Epilepsy Eagle Level PRINIVIL (lisinopril) Hypertension Eagle Level PRINIVIL (lisinopril) Congestive heart failure PRINIVIL (lisinopril) Heart attack 12 months PRINZIDE (lisinopril/hydrochlorothiazide) Hypertension Eagle Level PRISTIQ Depression Eagle Level PROAIR HFA (albuterol) Asthma Eagle Level PROBENECID Gout Eagle Level PROCARDIA (nifedipine) Hypertension Eagle Level prochlorperazine (COMPRO) Nausea/vomiting Eagle Level PROCHLORPERAZINE MALEATE Nausea/vomiting, severe Eagle Level (unless coupled w/cancer) PROCHLORPERAZINE MALEATE Schizophrenia/anxiety 24 months Eagle Level; decline PROCRIT (epoetin alfa) Cancer-related anemia 24 months PROCRIT (epoetin alfa) HIV-related anemia PROCRIT (epoetin alfa) Kidney disease-related anemia PROCTOFOAM HC Hemorrhoids Eagle Level PROCTOSOL HC Hemorrhoids Eagle Level PROGRAF (tacrolimus) Organ transplant rejection PROLIXIN (fluphenazine) Schizophrenia/psychotic disorder 24 months Eagle Level; decline PROMETHAZINE Cough/cold/allergies Eagle Level PROMETHAZINE HCL Antihistamine Eagle Level PROMETRIUM Hormonal treatment Eagle Level PROPAFENONE HCL Heart arrhythmia Eagle Level PROPANTHELINE BROMIDE Ulcers Eagle Level PROPECIA (finasteride) Male pattern baldness Eagle Level

50 Drug Name propoxyphene (DARVON) Pain relief - narcotic Eagle Level propoxyphene-n/acetaminophen Pain relief - narcotic Eagle Level propranolol (INDERAL) Hypertension Eagle Level propranolol (INDERAL) Migraine Eagle Level propranolol (INDERAL) Angina 12 months propranolol (INDERAL) Hypertrophic subaortic stenosis (cardiomyopathy) PROPYLTHIOURACIL Thyroid Eagle Level PROSCAR (finasteride) Benign prostatic hypertrophy Eagle Level PROSED/DS Urinary antibiotic Eagle Level PROTONIX (pantoprazole) GERD/ulcers Eagle Level PROTOPIC Dermatological treatment Eagle Level PROVENTIL (albuterol) Asthma Eagle Level PROVIGIL (modafinil) Narcolepsy (improves excessive sleepiness) Eagle Level PROZAC (fluoxetine) Depression/OCD/panic disorder 24 months Eagle Level; decline PRUDOXIN Dermatological treatment Eagle Level PSEUDOEPHEDRINE/GUAIFENESIN/ DEXTRO- METHORPHAN Cough/cold/allergies Eagle Level PSEUDOVENT 400 Cough/cold/allergies Eagle Level PURINETHOL (mercaptopurine) Cancer 24 months PYLERA Ulcers Eagle Level PYRIDOSTIGMINE BROMIDE Myasthenia gravis Eagle Level QDALL AR Antihistamine Eagle Level QUALAQUIN Malaria Eagle Level QUESTRAN (cholestyramine) Elevated cholesterol Eagle Level quetiapine (SEROQUEL) Schizophrenia/bipolar disorder 24 months Eagle Level; decline quinapril (ACCUPRIL) Hypertension Eagle Level quinapril/hydrochlorothiazide (QUINARETIC) Hypertension Eagle Level QUINARETIC (quinapril/hydrochlorothiazide) Hypertension Eagle Level QUINIDINE SULFATE Heart arrhythmia Eagle Level QUINIDINE SULFATE Malaria Eagle Level QVAR (beclomethasone) Asthma Eagle Level raloxifene (EVISTA) Osteoporosis Eagle Level ramelteon (ROZEREM) Insomnia Eagle Level ramipril (ALTACE) Hypertension Eagle Level ramipril (ALTACE) Congestive heart failure RANEXA (ranolazine) Angina 12 months RANITIDINE HCL Heartburn/indigestion Eagle Level ranolazine (RANEXA) Angina 12 months RAPAFLO Benign prostatic hypertrophy Eagle Level RAPAMUNE (sirolimus) Organ transplant rejection prevention rasagiline (AZILECT) Parkinson s disease Eagle Level p. 33

51 Prescription Drug Guide p. 34 Drug Name RAZADYNE (galantamine) Alzheimer s disease RE 10 WASH Dermatological treatment Eagle Level REBIF (interferon beta-1a) Multiple sclerosis Eagle Level RECLAST (zoledronic acid) Osteoporosis Eagle Level REGLAN (metoclopramide) GERD Eagle Level REGLAN (metoclopramide) REGLAN (metoclopramide) Diabetic gastroparesis (delayed digestion) Nausea and vomiting related to chemotherapy 24 months 24 months REGRANEX Dermatological treatment Eagle Level RELAFEN (nabumetone) Rheumatoid arthritis/osteoarthritis Eagle Level RELISTOR Constipation Eagle Level RELPAX Migraine Eagle Level REMERON (mirtazapine) Depression 24 months Eagle Level; decline RENACIDIN Kidney stones Eagle Level RENAGEL (sevelamer) Kidney disease RENAL Vitamin supplement Eagle Level RENVELA (sevelamer) Kidney disease repaglinide (PRANDIN) Diabetes Eagle Level (with no diabetic complications) REPLIVA 21/7 Iron supplementation Eagle Level REQUIP (ropinirole) Restless legs syndrome Eagle Level REQUIP (ropinirole) Parkinson s disease Eagle Level RESTASIS Eye drops Eagle Level RESTORIL (temazepam) Insomnia Eagle Level RETIN-A MICRO Dermatological treatment Eagle Level RETROVIR (zidovudine) HIV/AIDS REVIA (naltrexone) Alcohol dependence 24 months REVLIMID (lenalidomide) Cancer 24 months REYATAZ (atazanavir) HIV-related anemia RHINOCORT AQUA Nasal spray Eagle Level ribavirin (COPEGUS) Hepatitis C 24 months RIFAMPIN Tuberculosis RIMANTADINE HCL Influenza Eagle Level RINNOVI NAIL SYSTEM Dermatological treatment Eagle Level RIOMET (metformin) Diabetes Eagle Level (with no diabetic complications) risedronate (ACTONEL) Osteoporosis Eagle Level RISPERDAL (risperidone) Schizophrenia/bipolar disorder 24 months Eagle Level; decline risperidone (RISPERDAL) Schizophrenia/bipolar disorder 24 months Eagle Level; decline ritonavir (NORVIR) HIV/AIDS rivastigmine transdermal (EXELON) Alzheimer s disease/dementia ROBAXIN (methocarbamol) Muscle relaxer Eagle Level ROBINUL (glycopyrrolate) Ulcers Eagle Level ROCALTROL (calcitriol) Calcium replacement in PRIMARY parathyroid disease Eagle Level

52 ROCALTROL (calcitriol) Drug Name Kidney failure; SECONDARY parathyroid disease ROMAZICON (flumazenil) Drug overdose management 24 months ropinirole (REQUIP) Restless legs syndrome Eagle Level ropinirole (REQUIP) Parkinson s disease Eagle Level ROSAC Dermatological treatment Eagle Level rosiglitazone (AVANDIA) Diabetes Eagle Level (with no diabetic complications) rosuvastatin (CRESTOR) Elevated cholesterol Eagle Level ROWASA (mesalamine) Ulcerative colitis/proctitis Eagle Level ROZEREM (ramelteon) Insomnia Eagle Level R-TANNA Cough/cold/allergies Eagle Level SALKERA Dermatological treatment Eagle Level salmeterol (SEREVENT) Asthma Eagle Level salmeterol (SEREVENT) Chronic obstructive pulmonary disease (COPD) SALSALATE Pain relief - nonnarcotic Eagle Level SANCTURA XR Overactive bladder Eagle Level SANTYL Dermatological treatment Eagle Level SAVELLA (milnacipran) Fibromyalgia Eagle Level saxagliptin (ONGLYZA) Diabetes Eagle Level (with no diabetic complications) SECTRAL (acebutolol HCl) Hypertension Eagle Level SECTRAL (acebutolol HCl) Arrhythmia Eagle Level selegiline (ELDEPRYL, ZELAPAR) Parkinson s disease Eagle Level SELENIUM SULFIDE Dermatological treatment Eagle Level SENNA Constipation Eagle Level SENNA S Constipation Eagle Level SENSIPAR (cinacalcet) Primary parathyroid disease Eagle Level SENSIPAR (cinacalcet) Parathyroid cancer 24 months SENSIPAR (cinacalcet) Kidney disease SERAX (oxazepam) Anxiety Eagle Level SEREVENT DISKUS (salmeterol) Asthma Eagle Level SEREVENT DISKUS (salmeterol) Chronic obstructive pulmonary disease (COPD) SEROQUEL (quetiapine) Schizophrenia/bipolar disorder 24 months Eagle Level; decline sertraline (ZOLOFT) Depression Eagle Level sevelamer (RENAGEL, RENVELA) Kidney disease SILVER SULFADIAZINE Dermatological treatment Eagle Level SIMCOR (simvastatin/niacin) Elevated cholesterol Eagle Level SIMPONI (golimumab) Rheumatoid arthritis/psoriatic arthritis Eagle Level SIMPONI (golimumab) Ankylosing spondylitis Eagle Level simvastatin (ZOCOR) Elevated cholesterol Eagle Level simvastatin/niacin (SIMCOR) Elevated cholesterol Eagle Level SINEMET (carbidopa/levodopa) Parkinson s disease Eagle Level p. 35

53 Prescription Drug Guide p. 36 Drug Name SINEQUAN (doxepin HCl) Depression/anxiety Eagle Level SINGULAIR (montelukast) Allergies/asthma Eagle Level sirolimus (RAPAMUNE) Organ transplant rejection prevention sitagliptin (JANUVIA) Diabetes Eagle Level (with no diabetic complications) SKELAXIN Muscle relaxer Eagle Level SODIUM SULFACETAMIDE Eye drops Eagle Level SOLARAZE Dermatological treatment Eagle Level SOLTAMOX (tamoxifen) Breast cancer/cancer remission maintenance 24 months SONATA (zaleplon) Insomnia Eagle Level sorafenib (NEXAVAR) Cancer 24 months SORBITOL Constipation Eagle Level SORBUTUSS Cough/cold/allergies Eagle Level SORIATANE Dermatological treatment Eagle Level SORIATANE CK Dermatological treatment Eagle Level SORINE (sotalol) Heart arrhythmia Eagle Level sotalol (BETAPACE, SORINE) Heart arrhythmia Eagle Level SPECTRACEF Antibiotic Eagle Level SPIRIVA (tiotropium) Chronic obstructive pulmonary disease (COPD) spironolactone (ALDACTONE) Hyperaldosteronism/low potassium Eagle Level spironolactone (ALDACTONE) Hypertension Eagle Level spironolactone (ALDACTONE) Liver cirrhosis spironolactone (ALDACTONE) Congestive heart failure spironolactone (ALDACTONE) Kidney disease STALEVO 100 Parkinson s disease Eagle Level STARLIX (nateglinide) Diabetes Eagle Level (with no diabetic complications) STRATTERA ADHD Eagle Level STROMECTOL Worm infection Eagle Level STROVITE ADVANCE Vitamin supplement Eagle Level SUBOXONE Opiate dependency 24 months SUBSYS (fentl) sublingual spray Cancer pain 24 months SUBUTEX Opiate dependency 24 months SUCRALFATE Ulcers Eagle Level SULAR (nisoldipine) Hypertension Eagle Level SULFAMETHOXAZOLE/TRIMETHOPRIM DS Antibiotic Eagle Level SULFASALAZINE Ulcerative colitis Eagle Level SULINDAC Pain relief - anti-inflammatory Eagle Level sumatriptan (IMITREX) Migraine Eagle Level SUSTIVA (efavirenz) HIV/AIDS SYMBICORT (budesonide/formoterol) Asthma Eagle Level SYMBICORT (budesonide/formoterol) Chronic obstructive pulmonary disease (COPD)

54 Drug Name SYMBYAX (fluoxetine/olanzapine) Depression/bipolar disorder Eagle Level SYMLIN (pramlintide) Diabetes Eagle Level (with no diabetic complications) SYMMETREL (amantadine HCl) Parkinson s disease Eagle Level SYMMETREL (amantadine HCl) Drug-induced movement disorders Eagle Level SYNTHROID Thyroid Eagle Level SYNVISC Osteoarthritis Eagle Level SYSTANE Eye drops Eagle Level TACLONEX Dermatological treatment Eagle Level tacrolimus (PROGRAF) Organ transplant rejection tadalafil (CIALIS) Erectile dysfunction Eagle Level TAGAMET (cimetidine) Heartburn Eagle Level TAMBOCOR (flecainide) Heart arrhythmia Eagle Level TAMIFLU Influenza Eagle Level tamoxifen (SOLTAMOX) Breast cancer/cancer remission maintenance 24 months tamsulosin (FLOMAX) Benign prostatic hypertrophy Eagle Level TANDEM Iron supplementation Eagle Level TARKA (trandolapril/verapamil) Hypertension Eagle Level TAXOTERE (docetaxel) Cancer 24 months TEBAMIDE Nausea/vomiting Eagle Level TEGRETOL (carbamazepine) Epilepsy Eagle Level TEGRETOL (carbamazepine) Facial nerve disorder Eagle Level TEKTURNA (aliskiren) Hypertension Eagle Level TEKTURNA HCT (aliskiren/hydrochlorothiazide) Hypertension Eagle Level temazepam (RESTORIL) Insomnia Eagle Level TENEX (guanfacine) Hypertension Eagle Level tenofovir (VIREAD) Hepatitis B 24 months tenofovir (VIREAD) HIV/AIDS TENORETIC (atenolol/chlorthalidone) Hypertension Eagle Level TENORMIN (atenolol) Hypertension Eagle Level TENORMIN (atenolol) Angina 12 months TENORMIN (atenolol) Heart attack 12 months TENUATE (diethylpropion) Obesity Eagle Level (refer build chart) terazosin (HYTRIN) Benign prostatic hypertrophy Eagle Level terbutaline (BRETHINE, BRICANYL) Asthma/bronchitis Eagle Level terbutaline (BRETHINE, BRICANYL) Emphysema TERCONAZOLE Fungal infection Eagle Level TESTOSTERONE CYPIONATE Hormonal treatment Eagle Level TESTOSTERONE PROPIONATE Hormonal treatment Eagle Level TESTRED (methyltestosterone) Males: hormonal treatment Eagle Level TESTRED (methyltestosterone) Females: Inoperable breast cancer 24 months TETRACAINE HCL Eye drops Eagle Level TETRACYCLINE HCL Antibiotic Eagle Level p. 37

55 Prescription Drug Guide p. 38 Drug Name THALITONE (chlorthalidone) Hypertension Eagle Level THALITONE (chlorthalidone) Congestive heart failure THALITONE (chlorthalidone) Liver cirrhosis THALITONE (chlorthalidone) Edema related to estrogen therapy Eagle Level THALOMID Cancer 24 months THEOPHYLLINE Asthma Eagle Level THEOPHYLLINE Emphysema THIAMINE HCL Vitamin supplement Eagle Level THIORIDAZINE HCL Schizophrenia/psychotic disorder 24 months Eagle Level; decline THIOTHIXENE Schizophrenia 24 months Eagle Level; decline THORAZINE (chlorpromazine HCl) Schizophrenia/psychotic disorder 24 months Eagle Level; decline tiagabine (GABITRIL) Seizures Eagle Level TIAZAC (diltiazem) Hypertension Eagle Level TIAZAC (diltiazem) Angina 12 months TICLID (ticlopidine) Stroke 12 months TICLID (ticlopidine) Clot prevention after heart stent placement 12 months ticlopidine (TICLID) Stroke 12 months ticlopidine (TICLID) Clot prevention after heart stent placement 12 months TIKOSYN (dofetilide) Heart arrhythmia Eagle Level TIMOLOL MALEATE OPHTHALMIC GEL FORMING Eye drops Eagle Level TINDAMAX Antibiotic Eagle Level tiotropium (SPIRIVA) Chronic obstructive pulmonary disease (COPD) TIZANIDINE HCL Muscle relaxer Eagle Level TOBI Antibiotic Eagle Level TOBRADEX Eye drops Eagle Level TOBRAMYCIN SULFATE Eye drops Eagle Level TOFRANIL (imipramine) Depression Eagle Level TOLNAFTATE Dermatological treatment Eagle Level TOPAMAX (topiramate) Epilepsy Eagle Level TOPAMAX (topiramate) Migraine Eagle Level topiramate (TOPAMAX) Epilepsy Eagle Level topiramate (TOPAMAX) Migraine Eagle Level TOPROL-XL (metoprolol) Hypertension Eagle Level TOPROL-XL (metoprolol) Angina 12 months TOPROL-XL (metoprolol) Congestive heart failure torsemide (DEMADEX) Hypertension Eagle Level torsemide (DEMADEX) Liver disease torsemide (DEMADEX) Congestive heart failure torsemide (DEMADEX) Kidney disease TOVIAZ Overactive bladder Eagle Level TRAMADOL HCL Moderate to severe pain - narcotic Eagle Level

56 Drug Name TRANDATE (labetalol) Hypertension Eagle Level trandolapril (MAVIK) Hypertension Eagle Level trandolapril (MAVIK) Congestive heart failure trandolapril/verapamil (TARKA) Hypertension Eagle Level TRANSDERM-SCOP Nausea/vomiting Eagle Level TRANXENE (clorazepate dipotassium) Anxiety disorder Eagle Level TRANXENE (clorazepate dipotassium) Seizures Eagle Level TRANXENE (clorazepate dipotassium) Alcohol withdrawal 24 months TRAVATAN Eye drops Eagle Level trazodone (DESYREL) Depression Eagle Level TRENTAL (pentoxifylline) Circulation disorder Eagle Level TRETINOIN Dermatological treatment Eagle Level TREXIMET Migraine Eagle Level TRIAMCINOLONE ACETONIDE Dermatological treatment Eagle Level triamcinolone oral inhalation (AZMACORT) Asthma Eagle Level triamterene/hydrochlorothiazide (DYAZIDE, MAXZIDE) Hypertension Eagle Level triamterene/hydrochlorothiazide (DYAZIDE, MAXZIDE) Edema Eagle Level triazolam (HALCION) Insomnia Eagle Level TRICOR (fenofibrate) Elevated cholesterol/triglycerides Eagle Level TRIFLUOPERAZINE HCL Schizophrenia/anxiety 24 months Eagle Level; decline TRIFLURIDINE Eye drops Eagle Level trihexyphenidyl (ARTANE) Parkinson s disease Eagle Level TRILEPTAL (oxcarbazepine) Seizures Eagle Level TRILIPIX Elevated cholesterol/triglycerides Eagle Level TRI-LUMA Dermatological treatment Eagle Level TRILYTE Constipation Eagle Level TRIMETHOBENZAMIDE HCL Nausea/vomiting Eagle Level TRIMETHOPRIM Antibiotic Eagle Level TRIPLE ANTIBIOTIC Dermatological treatment Eagle Level TRIXAICIN HP Dermatological treatment Eagle Level TROPICAMIDE Eye drops Eagle Level TRUSOPT Eye drops Eagle Level TRUVADA (emtricitabine/tenofovir) HIV/AIDS TUSNEL-HC Cough/cold/allergies Eagle Level TUSSI-12D Cough/cold/allergies Eagle Level TUSSIONEX PENNKINETIC EXTENDED RELEASE Cough/cold/allergies Eagle Level TYGACIL Antibiotic Eagle Level TYLENOL WITH CODEINE #3 (acetaminophen with codeine #3) Pain relief - narcotic Eagle Level UDAMIN SP Vitamin supplement Eagle Level ULORIC Gout Eagle Level ULTRACET Pain relief - narcotic Eagle Level UMECTA PD Dermatological treatment Eagle Level p. 39

57 Prescription Drug Guide p. 40 Drug Name UNIRETIC (hydrochlorothiazide/moexipril) Hypertension Eagle Level UNIVASC (moexipril) Hypertension Eagle Level UREA Dermatological treatment Eagle Level URISED Urinary antibiotic Eagle Level UROQID #2 Urinary antibiotic Eagle Level UROXATRAL Benign prostatic hypertrophy Eagle Level URSO (ursodiol) Gallstones Eagle Level URSO (ursodiol) Liver cirrhosis ursodiol (ACTIGALL, URSO) Gallstones Eagle Level ursodiol (ACTIGALL, URSO) Liver cirrhosis UTA Urinary antibiotic Eagle Level VALCYTE (valganciclovir) Cytomegalovirus-AIDS VALCYTE (valganciclovir) Cytomegalovirus-organ transplant valganciclovir (VALCYTE) Cytomegalovirus-AIDS valganciclovir (VALCYTE) Cytomegalovirus-organ transplant VALIUM (diazepam) Anxiety disorder Eagle Level VALIUM (diazepam) Convulsive disorder/muscle spasms Eagle Level VALIUM (diazepam) Alcohol withdrawal 24 months VALPROIC ACID Seizures Eagle Level valsartan (DIOVAN) Hypertension Eagle Level valsartan (DIOVAN) Congestive heart failure valsartan (DIOVAN) Treatment after heart attack 12 months VALTREX Cold sores/herpes/chickenpox Eagle Level VALTURNA Hypertension Eagle Level VANCOCIN HCL Antibiotic Eagle Level VANIQA Dermatological treatment Eagle Level varenicline (CHANTIX) Smoking cessation 12 months smoking rates () VASERETIC (enalapril/hydrochlorothiazide) Hypertension Eagle Level VASOTEC (enalapril) Hypertension Eagle Level VASOTEC (enalapril) Congestive heart failure VAZOTAN Cough/cold/allergies Eagle Level VAZOTUSS HC Cough/cold/allergies Eagle Level venlafaxine (EFFEXOR) Depression/anxiety Eagle Level VENTOLIN (albuterol) Asthma Eagle Level VERAMYST Nasal allergy symptoms Eagle Level verapamil (CALAN, COVERA-HS, ISOPTIN, VERELAN) Hypertension Eagle Level verapamil (CALAN, COVERA-HS, ISOPTIN, VERELAN) Angina 12 months verapamil (CALAN, COVERA-HS, ISOPTIN, VERELAN) Arrhythmia Eagle Level VERELAN (verapamil) Hypertension Eagle Level VERELAN (verapamil) Angina 12 months VERELAN (verapamil) Arrhythmia Eagle Level VERTIGOHEEL Vertigo Eagle Level VESICARE Overactive bladder Eagle Level

58 Drug Name VFEND Fungal infection Eagle Level VIAGRA Erectile dysfunction Eagle Level VICKS NYQUIL Cough/cold/allergies Eagle Level VICTOZA (liraglutide) Diabetes Eagle Level (with no diabetic complications) VIGAMOX Eye drops Eagle Level VIMOVO Pain relief- anti-inflammatory Eagle Level VIREAD (tenofovir) Hepatitis B 24 months VIREAD (tenofovir) HIV/AIDS VIVITROL (naltrexone) Alcohol dependence/opiate dependence 24 months VYTORIN Elevated cholesterol Eagle Level VYVANSE ADHD Eagle Level warfarin (COUMADIN) Clot prevention after heart valve placement 12 months warfarin (COUMADIN) Atrial fibrillation Eagle Level WELCHOL (colesevelam) Elevated cholesterol Eagle Level WELCHOL (colesevelam) Diabetes Eagle Level (with no diabetic complications) WELLBUTRIN (bupropion) Depression Eagle Level XALATAN Eye drops Eagle Level XELODA (capecitabine) Cancer 24 months XENADERM Dermatological treatment Eagle Level XENICAL Obesity Eagle Level XERAC AC Dermatological treatment Eagle Level XIBROM Eye drops Eagle Level XIFAXAN Antibiotic Eagle Level XOPENEX Asthma Eagle Level XPECT-AT Cough/cold/allergies Eagle Level XYZAL Antihistamine Eagle Level ZADITOR Eye drops Eagle Level zafirlukast (ACCOLATE) Asthma Eagle Level zaleplon (SONATA) Insomnia Eagle Level ZAROXOLYN (metolazone) Hypertension Eagle Level ZAROXOLYN (metolazone) Congestive heart failure ZAROXOLYN (metolazone) Kidney disease ZEGERID (omeprazole/sodium bicarbonate) Ulcers/GERD/esophagitis Eagle Level ZELAPAR (selegiline) Parkinson s disease Eagle Level ZEMPLAR (paricalcitol) Kidney disease ZESTORETIC (lisinopril/hydrochlorothiazide) Hypertension Eagle Level ZESTRIL (lisinopril) Hypertension Eagle Level ZESTRIL (lisinopril) Congestive heart failure ZESTRIL (lisinopril) Heart attack 12 months ZETIA (ezetimibe) Elevated cholesterol Eagle Level ZIAGEN (abacavir) HIV/AIDS p. 41

59 Prescription Drug Guide Drug Name zidovudine (RETROVIR) HIV/AIDS ZINC SULFATE Mineral supplementation Eagle Level ziprasidone (GEODON) Schizophrenia/bipolar disorder 24 months Eagle Level; decline ZOCOR (simvastatin) Elevated cholesterol Eagle Level ZOFRAN (ondansetron) Nausea/vomiting related to chemotherapy 24 months zoledronic acid (RECLAST, ZOMETA) Osteoporosis Eagle Level ZOLOFT (sertraline) Depression Eagle Level zolpidem tartrate (AMBIEN) Insomnia Eagle Level ZOMETA (zoledronic acid) Osteoporosis Eagle Level ZOMIG Migraine Eagle Level ZONEGRAN (zonisamide) Epilepsy Eagle Level zonisamide (ZONEGRAN) Epilepsy Eagle Level ZOTANE HC External ear infection Eagle Level ZOVIRAX Herpes Eagle Level ZOVIRAX (acyclovir) Shingles/chickenpox/genital herpes Eagle Level ZYBAN (bupropion) Smoking cessation 12 months Eagle Level ZYLET Eye drops Eagle Level ZYMAR Eye drops Eagle Level ZYPREXA (olanzapine) Schizophrenia/bipolar disorder Eagle Level ZYRTEC Antihistamine Eagle Level ZYRTEC-D Cough/cold/allergies Eagle Level ZYVOX Antibiotic Eagle Level p. 42

60 p. 43

61 Americo Financial Life and Annuity Insurance Comp 300 W. 11th Street Kansas City, MO About Americo For over 100 years, Americo Life, Inc. s family of insurance companies has been committed to providing the life insurance and annuity products you need to protect your mortgage, family, and future. 1 We listen to what you want from an insurance policy or annuity and do our best to provide a proper solution for your individual situation. Innovative thinking and sound investment decisions have helped us build a strong financial foundation for our business. Today, Americo Financial Life and Annuity Insurance Comp is the lead comp in one of the largest independent, privately held insurance groups in the United States 2, with 660,000 policies, over $32.7 billion of life insurance in force, and $6.0 billion in assets for year-end Americo Life, Inc. is a holding comp and is not responsible for the financial condition or contractual obligations of its affiliate insurance companies. 2 Admitted Assets, Top Life Writers-2013, A.M. Best Co., as of July Information is as of year end 2013 on a consolidated basis for Americo Financial Life and Annuity Insurance Comp and the other life insurance subsidiaries of Americo Life, Inc., unless otherwise indicated. Information is prepared on the basis of generally accepted accounting principles (GAAP). Important Information Americo Financial Life and Annuity Insurance Comp is authorized to conduct business in the District of Columbia and all states except NY and VT. Products are underwritten by Americo Financial Life and Annuity Insurance Comp (Americo), Kansas City, MO, and may vary in accordance with state laws. Some products and benefits may not be available in all states. Some riders are optional and available for an additional cost. Certain restrictions and variations apply. Consult policy and riders for all limitations and exclusions. For exact terms and conditions, please refer to the contract. The comp reserves the right to contest coverage for up to two years due to misrepresentations in the application. If the insured, sane or insane, dies by suicide while the contract is in force and within two years (one year in Colorado, Missouri, and North Dakota) after the issue date, the proceeds payable will be limited to the sum of premiums paid, less indebtedness. See Missouri contract for special provisions regarding suicide. Neither Americo Financial Life and Annuity Insurance Comp nor agent representing Americo Financial Life and Annuity Insurance Comp is authorized to give legal or tax advice. Please consult a qualified professional regarding the information and concepts contained in this material.