Page 8 - 2016 Enrollment

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Pharmacy Plans

Tier I (generally consists of generic When you enroll in one of the Thompson Coburn medical plans, you
medication): If you use a generic automatically receive coverage for prescription drugs at no additional
medication, you’ll typically pay a
lower price. When you use a generic premium.
medication, you get the same for
less—brand-name medications and The HDP requires you to pay the cost of your prescriptions (with the
their generic equivalents contain the
same active ingredients, and are often exception of preventive prescription medications) until you meet your
made by the same companies, but deductible; once you meet the deductible, you pay 20 percent of the cost
the brand-name versions can be many
times more costly. of prescriptions until you reach the out-of-pocket maximum.
Tier II (generally consists of preferred
brand-name medications): If you use Under the POS plan, you pay the cost of prescription medications until
a Tier II medication, you pay a higher you reach the deductible. If the deductible is met, you then pay 20 percent
price than you would if you had used a
Tier I medication. A Tier II medication of the cost of prescriptions until you reach the out-of-pocket maximum.
is a patented prescription that appears
on the plan’s preferred prescription list. Prescriptions can be purchased from in-network retail pharmacies or by
Medications on this list are preferred
by the plan for their combination of mail order. The amount of your prescription depends on the type of
safety, effectiveness and cost. medication your doctor prescribes, and where you choose to purchase the
Tier III (generally consists of non-
preferred brand-name medications): If prescription.
you use a non-preferred medication,
you pay a higher price than Tier II. A Preventive Prescription Medications—No Cost Under the
Tier III medication does not appear
on the plan’s preferred prescription HDP
medication list. This usually means
that a generic or preferred medication Preventive prescription medications are covered at 100 percent (in-network only)
can be equally effective but at a lower under the Thompson Coburn HDP. Preventive prescription medications do not
cost. apply toward the deductible. This allows HDP participants to receive preventive
prescription medications without having to meet the deductible. Visit TC Connect
for the list of preventive prescription medications.

2016 Pharmacy Plan Design Comparison Chart
Pharmacy Coverage *
POS Plan HDP
Retail Purchase (30-day supply)
Tier I Covered 80% after deductible Covered 80% after deductible
Tier II Covered 80% after deductible Covered 80% after deductible
Tier III Covered 80% after deductible Covered 80% after deductible
Mail Order Purchase (90-day supply)
You pay the discounted price of a three month supply of You pay the discounted price of a three month supply of
a prescription medication until you reach the combined a prescription medication until you reach the combined
medical/pharmacy deductible. After the deductible is met, medical/pharmacy deductible. After the deductible is met,
you pay 20% of the discounted price until the out-of- you pay 20% of the discounted price until the out-of-
pocket maximum is met. pocket maximum is met.
Preventive Prescription Medications
Covered 80% after deductible Covered at 100%

* In-network coverage only

Thompson Coburn LLP