Page 11 - 2022 Clari Open Enrollment Benefits Guide

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Prescription Drugs
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Your medical plan includes prescription drug coverage. You pay a Quick Tip
different copayment depending on the “tier” or class of drug. Generic You should always use a participating
drugs are always the least expensive. You’ll pay more for brand name pharmacy (one that is contracted by your
drugs and drugs not on the formulary list. medical plan) to get the best price. You can
access a list of pharmacies through your
A formulary is a list of drugs that are preferred by the plan. Plans plan’s website or by calling member services.
use formularies to make sure members are using the most cost- This is especially important in a High
effective drugs. You can learn more about your plan’s prescription Deductible Health plan because you pay the
drug coverage, including what drugs are on the formulary, by visiting full cost of your prescription drugs until you
your plan’s website. Cigna's formulary can be found here. Select the meet your deductible.
Advantage formulary.

Terms to Know

As you choose your medical plan, consider the following types of costs and how they compare from plan to plan:

Deductible Coinsurance Copayment Out-of-Pocket Maximum
The amount you must pay When you pay a percentage A fixed amount you pay for a Protects you from big
before the plan begins sharing of the cost and your insurance service. Copayments are paid medical bills. This is the most
in the costs. You pay this pays the rest, your share is up front at the time of service. you would pay for eligible
full amount out-of-pocket, if called “coinsurance” amount. There may be different copay expenses during a plan year.
required by your plan. The High Say you’ve met your deductible. amounts for different services. Once the out-of-pocket max
Deductible Health Plan and the If your plan has a 20% For example, your copay for is met, the plan pays 100%
PPO Plan have this feature. coinsurance for an in-network generic Rx is $10. of the usual, customary and
X-ray, and your recent X-ray was reasonable (UCR) rates.
$100, you will owe $20.

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