Gender-Specific Drugs

Gender-specific drugs are those exclusively indicated for either male or female patients.

HMSA's point-of-sale gender edit results in denial of claims submitted for drugs dispensed to patients of the “wrong” gender.

The edit assists HMSA in maintaining benefit integrity for non-covered drugs.

Following is a list of gender-specific drugs, subject to change, which are currently affected by this edit.

Exclusive Male Drugs

• Erectile Dysfunction
• Testosterone – all forms

Exclusive Female Drugs

• Infertility
• Estrogen – all forms
• Contraception – all forms

Revision History