PRESCRIPTION DRUG BENEFITS
When you are covered by one of the Airports Authority medical plan options, you also automatically receive prescription drug coverage.
UNITEDHEALTHCARE CHOICE AND CHOICE PLUS OPTIONS( MEMBER CHOICE: ADMINISTERED BY EXPRESS SCRIPTS)
Retail Pharmacy Copay( up to a 30-day supply)
Maintenance Medication Copay( mail service or in-network pharmacy, up to a 90-day supply)
Mail Order( up to a 90-day supply)
Generic $ 10 copay * $ 20 copay * $ 20 copay * Preferred Brand $ 30 copay $ 60 copay $ 60 copay Non-Preferred Brand $ 50 copay $ 100 copay $ 100 copay Specialty N / A N / A $ 150 copay
Fill Limit for Maintenance( longterm) Medications
Lifetime fill limit: 2 Maintenance medications( 30-day supply) filled at any network retail pharmacy.
No lifetime fill limits. Maintenance medications( 90-day supply) may be filled through the mail service or an in-network( CVS or Walgreens) pharmacy.
No lifetime fill limit
* Have a prescription for a drug you have never taken filled with a generic drug, and the first two fills are free!
If you have a prescription filled with a preferred or nonpreferred brand name drug when a generic is available, and your doctor writes the prescription to be dispensed as written( DAW), you will pay the appropriate brand name drug copay.
However, if you have a prescription filled with a preferred or non-preferred brand name drug when a generic drug is available, and you request the brand name drug, you will pay the appropriate copay plus the difference in cost between the brand name drug and the generic drug.
FILLING YOUR PRESCRIPTIONS
If you are enrolled in UnitedHealthcare Choice or Choice Plus, your prescription drug benefits are administered by Express Scripts.
You can use mail order or your customized CVS or Walgreens Member Choice Pharmacy Network for maintenance medications.
One-time prescriptions or the first two fills of a maintenance medication can also be filled at retail pharmacies.
Kaiser Permanente plan members receive their prescriptions through Kaiser.
SAVEONSP
SaveOnSP helps manage questions, treatment plans and costs when certain drugs are prescribed for UHC Choice and Choice Plus members. If prescribed a SaveOnSP covered medication, Express Scripts will work with SaveOnSP to invite you into the program, and reduce your financial responsibility for the medication to zero.
GLP-1 MEDICATION COVERAGE
Beginning Jan. 1, GLP-1 medications will not be covered when prescribed only for weight loss. Coverage is not affected if prescribed for a diagnosis other then weight loss, such as Type 2 Diabetes. For additional information about this change and options for continuing to take GLP-1s for weight loss, please see page 3.
KAISER PERMANENTE HMO Filled at Kaiser Facility
Filled at Participating Retail Pharmacy
Mail Order( up to a 90-day supply)
Generic |
$ 10 copay |
$ 20 copay |
$ 20 copay |
Preferred Brand |
$ 20 copay |
$ 40 copay |
$ 40 copay |
Non-Preferred Brand |
$ 40 copay |
$ 55 copay |
$ 80 copay |
Specialty |
$ 40 copay |
$ 55 copay |
$ 80 copay |
9 | METROPOLITAN WASHINGTON AIRPORTS AUTHORITY