In 2022 the Prescription Drug plan is switching from OptumRx to Elixir Rx.
Specialty drugs: Are ordered through the Elixir Rx mail order program. Elixir has implemented many Rx savings tools that you may be contacted about, including maximizing manufacturer’s coupons, brand name exclusions, etc. Keep in mind that participating in these programs will save you money up front and, if the result lowers the overall cost of prescriptions, will save you money long term by keeping the cost of the medical/Rx plan stable.
Maintenance Rx: You will often pay a reduced cost for maintenance prescriptions ordered via the mail order program; however, 90-day supplies of maintenance Rx’s can also be picked up at any in-network pharmacy at a reduced cost.
UHC Copay Rx Plan:
The CoPay medical plan includes a 4-tier copay prescription drug plan with in-network copays of $15, $50, $70 and 25% specialty Rx.
HDP/HSA Rx Plan:
With the HDP/HSA plan there are no copays, participants pay the full contracted rate for all services including prescription drugs up until the participant’s deductible ($3000) has been satisfied, and then 10% of the cost until the participant’s maximum-out-of-pocket ($4000) amount has been met. All out-of-pocket costs apply to the member’s deductible & maximum out of pocket.
Health Savings Account (HSA)funds can be used to cover the cost of prescriptions, medical, dental & vision out-of-pocket costs. If funds are not readily available at the time the Rx is filled, the employee can reimburse themselves later when there are funds in their HSA (provided that the charges occurred after the initial date the HSA was set up).