Officers - Prescription Drug Coverage | Human Resources
Officers - Prescription Drug Coverage
When you enroll in any University medical plan, you are automatically enrolled in the Prescription Drug plan, administered by OptumRx.
To find participating pharmacies or enroll in the OptumRx mail-order program, log in to myuhc.com and choose “Manage Your Prescriptions” or call 800-232-9357 for assistance.
The cost of prescriptions depends on a number of factors, including the medical plan in which you are enrolled, whether you buy your medication through a retail pharmacy or through the mail-order program, and whether the drug is generic, single-source or multi-source.
Copays for prescription drugs work differently under the Choice Plus plans and the High Deductible Health Plan (HDHP).
Under the Choice Plus plans, all prescription drugs are subject to a copay.
Under the High Deductible Health Plan (HDHP), preventive drugs and nonpreventive drugs are treated as follows:
Preventive Drugs: Prescription drugs categorized as “preventive” under federal guidelines are not subject to the HDHP deductible, so you are only responsible for paying the copay. Copays accumulate toward your out-of-pocket maximum. Preventive drugs under federal guidelines include medications such as anticoagulants, cholesterol lowering agents and prenatal vitamins. To check if your prescription is considered preventive, go to the Covered Preventive Medications List.
Non-Preventive Prescription Drugs: Prescription drugs categorized as “non-preventive” under federal guidelines are subject to the HDHP deductible. This means you will pay the entire cost for your non-preventive prescription drugs until you meet the plan deductible. Once the deductible is met, the prescription drug copay will apply. Note: you will receive a discount on the cost of your prescription drugs if you use an OptumRx participating pharmacy.
(up to 30-day
Non-Preventive Drugs
• Subject to HDHP in-network
deductible; then Rx copays apply
Choice Plus (80, 90, 100)
To check if your prescription is considered preventive, see the Covered Preventive Medications List.
Copays and deductibles accumulate toward the out-of-pocket maximum of all plans. After you reach the annual out-of-pocket maximum, the plans pay 100% of the cost of preventive and non-preventive prescription drugs.
Single-Source vs. Multi-Source
To find out if a drug is single-source or multi-source, ask your pharmacist or contact OptumRx at 800-232-9357 or www.myuhc.com. Keep in mind that your prescription may move from single-source to multi-source during the year due to periodic reviews by OptumRx or if the U.S. Food and Drug Administration (FDA) approves a generic equivalent drug.
If no generic is available for your prescription, your drug is "single-source" and you will pay $25.
Note: Non-preventive drugs in the HDHP are subject to the medical plan deductible. After the deductible is met, copays will apply.
To enroll log in to OptumRX mail-order program or find participating pharmacies, log in to myuhc.com and choose "Manage Your Prescriptions" then "Order Prescriptions" or call 800-232-9357 for assistance.
Call 855-427-4682 to speak to a patient care representative to get started. Typically, you will receive a 30-day supply of the prescription at the retail pharmacy copay.
Note: If you use any pharmacy other than Optum Specialty Pharmacy, you will be subject to the full cost of the medication, not a copay.