No matter which medical plan you choose, prescription drug coveragePrescription Drug CoverageThe part of your plan that helps pay for medications prescribed by your doctor. Costs can vary depending on what your medication is. is automatically included. Your cost for prescription drugs depends on the medical plan you enroll in.
If you’re enrolled in Surest or one of the UMR medical plans, your prescription drug coveragePrescription Drug CoverageThe part of your plan that helps pay for medications prescribed by your doctor. Costs can vary depending on what your medication is. is through Optum Rx. If you’re enrolled in a Kaiser plan, prescription drug coverage is through Kaiser.
Generic medications usually offer the lowest out-of-pocket cost for you. And they’re made with the same active ingredients as brand-name medications.
If you’re enrolled in an HDHP medical plan, you’ll pay the full cost for prescription drugs up until you’ve met your deductible. That means if your prescription is $400, you’ll pay that each time you get a fill, until your deductible is met for the year.
If so, you’ll pay nothing when you get your prescription filled at the pharmacy. Anything classified as preventive is 100% covered by the medical plan.
Not sure if you’re taking a preventive drug? Preventive medications are medications that help you stop something from happening, rather than treating it after it starts, like birth control pills, ACE inhibitors and beta-blockers. Contact your plan or your doctor if you have questions about any medications you’re taking.
*If you're enrolled in one of the UMR or Surest medical plans and take a specialty medication, you'll need to use the Optum Specialty Pharmacy.
**The maximum amount you’ll pay for a prescription varies based on where you live. See the plan document for detailed information.
If you’re prescribed a long-term medication (something that you’ll take beyond 90 days), you’ll save money and time if you use mail order to get 90-day refills. Mail order is a quick set up — you’ll just need to create an account, get your prescription submitted (by your doctor or transferred by you), and then check your mailbox. Your medications usually arrive within 3-5 days.
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