Skip To Main Content

Logo Image

Logo Title

Prescriptions

Prescriptions
rxbenefits
optum
 
 
RxBenefits is our pharmacy benefit manager with pharmacy benefit services provided by OptumRx.
*Specialty Medications 
Specialty medications are high-cost drugs that are often injected or infused and require special storage and monitoring. These medications must be obtained through OptumRX specialty pharmacy and are limited to a 30-day supply.  specialty medications are noted with the "SP" indicator on the formulary and will be subject to the Specialty co-insurance listed in the chart below. 
 
 
Contact Member Services Team if you have questions about your prescription claims.  
You can reach this team via email at RxHelp@rxbenefits.com or by phone at 
800-334-8134 during the hours of 7am - 8pm CT Monday-Friday.
 
Register online to view your pharmacy benefits at www.optumrx.com
OptumRx also has a Mobile App to help manage your account on-the-go, simply download on Google Play or the App Store.
 

OptumRx is offering this updated list of no-cost Preventive Care Medications. These products are available at no cost to you on both standard and high-deductible health plans. 

 You can use your UMR/OptumRx member ID card to get the products on this list for no cost if they are:

  • Prescribed by a health care professional
  • Age- and condition-appropriate
  • Filled at a network pharmacy

Prescription Drug Coverage

How the Medical Plans Cover Prescription Drugs

Prescription Coverage Health Savings Account (HSA) Plan Base Plan Buy-Up Plan
Retail Prescriptions  $10 Copay per prescription* $10 Copay per prescription $10 Copay per prescription
(up to 31-day supply)
Generic drugs
Preferred brand drugs

20% up to $100 per    script maximum*

 20% up to $100 per script maximum 20% up to $100 per         script maximum
Non-preferred brand drugs 20% up to $200 per    script maximum* 20% up to $200 per script maximum 20% up to $200 per         script maximum
Specialty Prescriptions
(up to 31-day supply)		 20% up to $300 per script maximum* 20% up to $300 per script maximum 20% up to $300 per         script maximum
Retail 90 Prescriptions  $20 Copay per $20 Copay per prescription $20 Copay per      prescription
(32-90-day supply) Prescription* 
Preferred brand drugs

20% up to $200 per    script maximum*

 20% up to $200 per script maximum 20% up to $200 per         script maximum
Non-preferred brand drugs 20% up to $400 per    script maximum* 20% up to $400 per script maximum 20% up to $400 per         script maximum
Mail Order Prescriptions $20 Copay per prescription* $20 Copay per prescription $20 Copay per      prescription
(32-90-day supply)
Generic drugs
Preferred brand drugs 20% up to $200 per    script maximum* 20% up to $200 per script maximum 20% up to $200 per         script maximum
Non-preferred brand drugs

20% up to $400 per    script maximum*

 20% up to $400 per script maximum 20% up to $400 per         script maximum

 

* How the medical Health Savings Account Plan covers prescription drugs: 

Under the Health Savings Account Plan, you will pay contracted cost of covered prescription drugs until you meet the medical deductible. Medical and pharmacy expenses are subject to the same medical deductible. After you meet the deductible, you pay the copay or coinsurance of covered prescription costs until you reach the combined medical and prescription drug out-of-pocket maximum. 

 

HSA Pharmacy Plan now includes the HSA Preventive Generics Medication List

All Plans = Mandatory Generic when available - Member pays the difference