5 Condition Page AIDS/HIV 6 ALLERGY/NASAL SPRAYS 6 ALZHEIMER’S DISEASE 6 ANXIETY/DEPRESSION/BIPOLAR DISORDER 6, 7 ASTHMA/COPD/RESPIRATORY 7, 8 ATTENTION DEFICIT HYPERACTIVITY DISORDER 8 BLOOD MODIFIERS/BLEEDING DISORDERS 8 BLOOD PRESSURE/HEART MEDICATIONS 8, 9 BLOOD THINNERS/ANTI-CLOTTING 9, 10 CANCER 10, 11 CHOLESTEROL MEDICATIONS 11 CONTRACEPTION PRODUCTS 11-14 COUGH/COLD MEDICATIONS 14 DENTAL PRODUCTS 14 DIABETES 14-16 DIURETICS 16 EAR MEDICATIONS 16 EYE CONDITIONS 16, 17 FEMININE PRODUCTS 17 Condition Page GASTROINTESTINAL/HEARTBURN 17, 18 HORMONAL AGENTS 18, 19 INFECTIONS 19. 20 INFERTILITY 20 MISCELLANEOUS 21 MULTIPLE SCLEROSIS 21, 22 NUTRITIONAL/DIETARY 22 OSTEOPOROSIS PRODUCTS 22 PAIN RELIEF AND INFLAMMATORY DISEASE 23, 24 PARKINSON’S DISEASE 24 SCHIZOPHRENIA/ANTI-PSYCHOTICS 24, 25 SEIZURE DISORDERS 25 SKIN CONDITIONS 25, 26 SLEEP DISORDERS/SEDATIVES 26 SUBSTANCE ABUSE 26 TRANSPLANT MEDICATIONS 26, 27 URINARY TRACT CONDITIONS 27 VACCINES 27, 28 VITAMINS 28 How to find your medication Medications are listed in alphabetical order (A-Z) by condition. Conditions are also listed in alphabetical order (A-Z). To see which page your medication is on, find your condition in the table below. Then, go to the page listed next to it to see which medications are covered. Letters (acronyms) in the Notes column (cont.) PPACA Health care reform under the Patient Protection and Affordable Care Act (PPACA) requires plans to cover the full cost of this preventive medication or product. This means you don't have to pay anything – not even a copay, coinsurance or deductible. OC Plans can choose to cover certain medications, products and/or drug classes that aren’t typically covered. If a medication has OC next to it, log in to the myCigna App or myCigna.com to see if your plan covers it.

Cigna - Formulary - Page 5 Cigna - Formulary Page 4 Page 6