Page 7 - 2015 New Hire Guide
P. 7
Fontbonne University
Pharmacy
Prescription beneits are included within the medical plan options
available to Fontbonne University faculty and staff. The prescription
beneits available are built around different pricing structures or “tiers”
that enable you to control the cost based on the types of medications
you select. When you obtain your medications at a pharmacy, you
will be responsible for satisfying a copay that will depend on the
medication. If you are enrolled in the HSA plan, you will irst need to
satisfy your deductible. However, the deductible is waived if you are
taking an approved maintenance medication.
Mail order program “3 months for 2” Copays
Prescription plan participants can use the mail order program to obtain
valuable savings when ordering up to 90 day supplies of maintenance
medications. Under this program, you pay an amount equal to two
times the retail copay for a 90 day supply of your prescription. Not all
drugs will qualify for the mail order drug program.
Premium Plan HSA Plan
In-Network In-Network
Deductible, then the following
copays: No deductible on
maintenance medications
Generic $10 $10
Preferred Brand $30 $30
Non-Preferred $50 $50
Brand
Mail Order 2 times above copays for 2 times above copays for 90 day
90 day supply supply
Note: If you purchase a prescription drug from a non-network pharmacy, you are responsible
for any difference between what the non-network pharmacy charges and the amount
that would have been paid for the same prescription drug dispensed by a network
pharmacy .
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Pharmacy
Prescription beneits are included within the medical plan options
available to Fontbonne University faculty and staff. The prescription
beneits available are built around different pricing structures or “tiers”
that enable you to control the cost based on the types of medications
you select. When you obtain your medications at a pharmacy, you
will be responsible for satisfying a copay that will depend on the
medication. If you are enrolled in the HSA plan, you will irst need to
satisfy your deductible. However, the deductible is waived if you are
taking an approved maintenance medication.
Mail order program “3 months for 2” Copays
Prescription plan participants can use the mail order program to obtain
valuable savings when ordering up to 90 day supplies of maintenance
medications. Under this program, you pay an amount equal to two
times the retail copay for a 90 day supply of your prescription. Not all
drugs will qualify for the mail order drug program.
Premium Plan HSA Plan
In-Network In-Network
Deductible, then the following
copays: No deductible on
maintenance medications
Generic $10 $10
Preferred Brand $30 $30
Non-Preferred $50 $50
Brand
Mail Order 2 times above copays for 2 times above copays for 90 day
90 day supply supply
Note: If you purchase a prescription drug from a non-network pharmacy, you are responsible
for any difference between what the non-network pharmacy charges and the amount
that would have been paid for the same prescription drug dispensed by a network
pharmacy .
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