Get the most from your prescription drug benefits

December 18, 2018

​You can save money when you choose prescription drugs on the preventive drug list and drug formulary.

​Before filling prescriptions in the new year, active members should check the 2019 preventive drug list and 2019 drug formulary. When you choose drugs on these lists, you can save money and get the medication you need to help you live a healthier life.

Your out-of-pocket costs will be the lowest when using medications that are on the preventive drug list, a special subset of the plan formulary. It includes select prescription drugs that are highly effective in preventing or managing chronic conditions, such as diabetes, high blood pressure, and osteoporosis. PPO and EPO members pay reduced copays for these designated preventive drugs. Those in the HDHP pay only a reduced copay with no deductible.*

The formulary is a broader list of preferred medications that are covered by the prescription drug program. The list is reviewed each year and may be updated. It’s especially important to check if your medication is on the 2019 formulary if you’re enrolled in the EPO or HDHP because these options do not cover non-formulary drugs. The PPO does cover them, but you’ll pay more out of pocket than you would for a generic or brand drug that is on the formulary.

If a drug you now take is not on one of these lists, you may want to discuss with your physician whether there’s a preventive or formulary drug that would be appropriate for you. If so, you’ll need a new prescription.

Also, keep in mind that certain drugs are excluded from coverage. If you fill a prescription for one of these excluded drugs, you will pay the full cost of the drug.

Medicare Supplement Plan

Retired members should check the 2019 drug formulary for Medicare Supplement Members. The Medicare Supplement prescription drug program is a qualified Medicare Part D plan and uses a separate formulary listing, which is subject to annual approval by the Centers for Medicare & Medicaid Services (CMS).

If you have questions about your prescription drug benefits, call OptumRx at 855-207-5868.

*Preventive drug benefits are available to employees and their family members enrolled in the active Medical Plan (the PPO, EPO, or HDHP); these benefits are not available to members enrolled in Triple-S, GeoBlue, or the Medicare Supplement Plan.