Page 15 - Demo

Prescription Plan
Benefits Summary
Cigna’s Essential Pharmacy Protection Utilization Package
Cigna Pharmacy Management® aims to help you maximize the value of your pharmacy benefit plan. The Essential Protection drug management package monitors appropriate use and helps direct customers to lower-cost drug options with similar outcomes.
Drug Quantity
• Helps ensure clinically appropriate quantity of dosing and duration of use.
• Mitigates drug waste/stockpiling.
Drug Prior Authorization
Oversight for certain branded and specialty drugs that helps ensure:
• Customer diagnosis matches clinical guidelines for use.
• Appropriate use of emerging/new drugs.
• Reduction of waste, error and unnecessary drug use (e.g., opioids).
• Outreach for specialty medication coaching, specialty condition support and holistic health coaching.
Drug Step Therapy
Promotes use of clinically effective, lower-cost drug before higher-cost option would be approved.
A medical necessity review is available for approval of a higher-cost drug.
Prescription Drug List:
Standard Rx Program subject to Refill-too-soon and Prior Authorization, Step Therapy, Quantity Limits etc. See Certificate of Coverage for details. 90-day retail available at all pharmacies.
Cigna Home Delivery Pharmacy
Using Cigna Home Delivery PharmacySM is an easy, reliable way to get your medications. In most cases, your cost will be lower than at a retail pharmacy.
Benefits of Cigna Home Delivery Pharmacy
Home Delivery is designed especially for individuals who take prescription medications on an ongoing basis.
When you choose Cigna Home Delivery Pharmacy to fill your ongoing medications, you can take advantage of the following:
• Licensed pharmacists available 24/7.
• Save money and valuable time by ordering up to a 90-day supply of your prescriptions at one time.
• Standard delivery to your home or other location at no additional cost.
• Reminders if you forget to refill your prescriptions.
Generics
Pharmacy Drug Copay
Retail
Retail 90 Day
Home Delivery 90 Day
$20
$60
$40
Preferred Brands
$50
$150
$100
Non-Preferred
$125
$375
$250
Cigna Specialty Pharmacy is for specialty medications which are different from traditional pharmacy medications. They are used to treat long-term, life-threatening or rare conditions. Find out more about specialty medications and download the prescription form by clicking here.
For additional information about Cigna Pharmacy coverage watch this video.
Ordering Methods
• Call 1.800.285.4812, Option 1. Ext 508.
• Fill out the Home Delivery Pharmacy
mail order form and mail in.
BPS Employee Benefits Guide | 15
HEALTH & WELLNESS