Page 4 - 2022 Iodine Software Benefit Guide

Medical and pharmacy plan overview

We offer the choice of three medical plans through Cigna. All of the medical options include coverage for prescription drugs.
To select the plan that best suits your family, you should consider the key differences between the plans, the cost of
coverage (including payroll deductions), and how the plan covers services throughout the year.

Understanding how your plan works

1. Your deductible 2. Your coverage 3. Your out-of-pocket maximum
You pay out-of-pocket for most Once your deductible is met, you and When you reach your out-of-pocket
medical and pharmacy expenses, the plan share the cost of covered maximum, the plan pays 100% of
except those with a copay, until you medical and pharmacy expenses covered medical and pharmacy
reach the deductible. with coinsurance. The plan will pay a expenses for the rest of the plan year.
You can pay for these expenses from percentage of each eligible expense, Your deductible and coinsurance apply
your Health Savings Account if you have and you will pay the rest. toward the out-of-pocket maximum
a HDHP (high deductible health plan), eligible health care expenses.
or your Flexible Spending Account if
you do not have a HDHP.

Making the most of your plan
Getting the most out of your plan also depends on how ● Pharmacy coverage: Medications are placed in categories
well you understand it. Keep these important tips in mind based on drug cost, safety and effectiveness. These tiers
when you use your plan. also affect your coverage.
● In-network providers and pharmacies: You will always ● Generic – A drug that offers equivalent uses, doses,
pay less if you see a provider within the medical and strength, quality and performance as a brand-name drug,
pharmacy network. but is not trademarked.
● Preventive care: In-network preventive care is covered ● Brand preferred – A drug with a patent and trademark
at 100% (no cost to you). Preventive care is often name that is considered “preferred” because it is
received during an annual physical exam and includes appropriate to use for medical purposes and is usually
immunizations, lab tests, screenings and other services less expensive than other brand-name options.
intended to prevent illness or detect problems before you ● Brand non-preferred – A drug with a patent and
notice any symptoms. trademark name. This type of drug is “not preferred” and
● Preventive drugs: Many preventive drugs and those is usually more expensive than alternative generic and
used to treat chronic conditions like diabetes, high blood brand preferred drugs.
pressure, high cholesterol and asthma are on the ● Specialty – A drug that requires special handling,
Preventive Condition Drug List. These prescriptions administration or monitoring. Most can only be
are covered at 100% (no cost to you) when you use an filled by a specialty pharmacy and have additional
in-network pharmacy. required approvals.

● Mail Order Pharmacy: If you take a maintenance
medication on an ongoing basis, you can use the Mail
Order Pharmacy to save on a 90-day supply.

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