Page 8 - Thompson Coburn 2021 Annual Benefits Enrollment
P. 8
PHARMACY PLANS
When you enroll in one of the Thompson Coburn 2021 Pharmacy Plan Design
HDP plans, you automatically receive coverage for Comparison Chart
prescription drugs at no additional premium.
Pharmacy Coverage*
The HDP plans require you to pay the cost of your Retail Purchase (30-day supply) HDP
prescriptions (with the exception of preventive Tier I Covered 80% after deductible
prescription medications) on the list until you meet Tier II Covered 80% after deductible
your deductible. Once you meet the deductible, you Tier III Covered 80% after deductible
pay 20% of the cost of prescriptions until you reach Mail Order Purchase (90-day supply)
the out-of-pocket maximum. You pay the discounted price of a 3-month supply of a
prescription medication until you reach the combined medical/
Prescriptions can be purchased from in-network retail pharmacy deductible; after the deductible is met, you pay
20% of the discounted price until the out-of-pocket maximum
pharmacies or by mail order. The amount of your is met
prescription depends on the type of medication your Preventive Prescription Medications
doctor prescribes, and where you choose to purchase Covered at 100%
the prescription. * In-network coverage only.
Tier I (generally consists of generic medication): If you
use a generic medication, you’ll typically pay a lower price.
Preventive Prescription When you use a generic medication, you get the same for
less—brand-name medications and their generic equivalents
Medications—No Cost Under contain the same active ingredients, and are often made by
Either HDP the same companies, but the brand-name versions can be
many times more costly.
Preventive prescription medications are covered at 100% Tier II (generally consists of preferred brand-name
(in-network only) under the Thompson Coburn HDP medications): If you use a Tier II medication, you pay
plans. Preventive prescription medications do not apply a higher price than you would if you had used a Tier I
toward the deductible. This allows HDP participants medication. A Tier II medication is a patented prescription
to receive preventive prescription medications without that appears on the plan’s preferred prescription list.
having to meet the deductible. Visit TC Connect under Medications on this list are preferred by the plan for their
the Human Resources page for the list of preventive combination of safety, efectiveness and cost.
prescription medications.
Tier III (generally consists of non-preferred brand-name
medications): If you use a non-preferred medication, you pay
a higher price than Tier II. A Tier III medication does not
appear on the plan’s preferred prescription medication list.
This usually means that a generic or preferred medication
can be equally efective but at a lower cost.
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When you enroll in one of the Thompson Coburn 2021 Pharmacy Plan Design
HDP plans, you automatically receive coverage for Comparison Chart
prescription drugs at no additional premium.
Pharmacy Coverage*
The HDP plans require you to pay the cost of your Retail Purchase (30-day supply) HDP
prescriptions (with the exception of preventive Tier I Covered 80% after deductible
prescription medications) on the list until you meet Tier II Covered 80% after deductible
your deductible. Once you meet the deductible, you Tier III Covered 80% after deductible
pay 20% of the cost of prescriptions until you reach Mail Order Purchase (90-day supply)
the out-of-pocket maximum. You pay the discounted price of a 3-month supply of a
prescription medication until you reach the combined medical/
Prescriptions can be purchased from in-network retail pharmacy deductible; after the deductible is met, you pay
20% of the discounted price until the out-of-pocket maximum
pharmacies or by mail order. The amount of your is met
prescription depends on the type of medication your Preventive Prescription Medications
doctor prescribes, and where you choose to purchase Covered at 100%
the prescription. * In-network coverage only.
Tier I (generally consists of generic medication): If you
use a generic medication, you’ll typically pay a lower price.
Preventive Prescription When you use a generic medication, you get the same for
less—brand-name medications and their generic equivalents
Medications—No Cost Under contain the same active ingredients, and are often made by
Either HDP the same companies, but the brand-name versions can be
many times more costly.
Preventive prescription medications are covered at 100% Tier II (generally consists of preferred brand-name
(in-network only) under the Thompson Coburn HDP medications): If you use a Tier II medication, you pay
plans. Preventive prescription medications do not apply a higher price than you would if you had used a Tier I
toward the deductible. This allows HDP participants medication. A Tier II medication is a patented prescription
to receive preventive prescription medications without that appears on the plan’s preferred prescription list.
having to meet the deductible. Visit TC Connect under Medications on this list are preferred by the plan for their
the Human Resources page for the list of preventive combination of safety, efectiveness and cost.
prescription medications.
Tier III (generally consists of non-preferred brand-name
medications): If you use a non-preferred medication, you pay
a higher price than Tier II. A Tier III medication does not
appear on the plan’s preferred prescription medication list.
This usually means that a generic or preferred medication
can be equally efective but at a lower cost.
8
