IMPORTANT NOTE ABOUT PRESCRIPTION DRUGS:
EFFECTIVE 1/1/2018 CVS & TARGET PHARMACIES ARE OUT OF NETWORK.
The Prescription Drug plan will be administered by OptumRx. Medical and Rx ID cards will be combined, so you’ll only need to carry one card.
ADVANTAGE (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% of actual cost.
Maintenance drugs are available via the Optum Rx mail order program – you will pay a reduced cost for maintenance prescriptions ordered via the mail order program. 90-day supplies of maintenance Rx’s can also be picked up at any in-network pharmacy at a reduced cost. Specialty drugs are available via mail order from Briova Rx – an Optum subsidiary company.
HDP Rx Plan:
With the HDP medical and prescription drug plan, all costs apply to the member’s deductible. For in-network claims, the member will pay the contracted rate for all services including prescription drugs up until the member’s deductible/maximum out of pocket has been satisfied.
Health Savings Account (HSA)funds can be used to cover the cost of the prescriptions (as well as allowed 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).