Coverage
| PPO Plan | HDHP 1 | HDHP 2 | |
|---|---|---|---|
| Prescription Drugs | |||
| Preventive Medications | Paid at 100% | Paid at 100% | Paid at 100% |
| Generic | $10 | 80% after deductible | 80% after deductible |
| Preferred | $35 | 80% after deductible | 80% after deductible |
| Non-Preferred | $60 | 80% after deductible | 80% after deductible |
| Specialty | 20% co-ins up to $200 | 80% after deductible | 80% after deductible |
| A RX mail order program and or retail store is also available which allows you to receive a 90-day supply of maintenance medication at one time for most prescriptions. Mail Order copays for the PPO plan will be 2.5 times the amount of retail copays. | |||
Mail Order
OptumRx Mail Service Pharmacy makes ordering maintenance medications easy and saves you both time and money compared to a retail pharmacy.
Preventive Medications
Your pharmacy benefit plan includes special coverage at 100% for preventive medications. These medications help protect against or manage a medical condition, such as:
- Preventing blood clots and reducing a risk of stroke
- Preventing heart disease and reducing high blood pressure
- Preventing osteoporosis
- Your health is important. Taking preventive medications as told by your healthcare provider can help you avoid serious illness and high health care costs.
Additionally Continuous Glucose Monitoring products are considered preventative therefore include special coverage at 100%.
Customer Service
OptumRx administers your pharmacy benefit plan on behalf of your plan sponsor, and we’re here to help you. In addition to answering questions about your plan, we may also be able to help you save money on your prescription medications.
Dedicated Customer Service
- 1-877-559-2955
- 24 hours a day, 7 days a week
Easy-to-use Website: www.optumrx.com
- Locate a pharmacy
- Account dashboard
- Consumer health education