Page 8 - 2017 Benefits Enrollment
P. 8
2017 BENEFITS ENROLLMENT
Pharmacy Plans When you enroll in one of the Thompson Coburn medical plans,
you automatically receive coverage for prescription drugs at no
` additional premium.
Tier I (generally consists of generic
medication): If you use a generic The HDP requires you to pay the cost of your prescriptions (with
medication, you’ll typically pay a
lower price . When you use a generic the exception of preventive prescription medications) until you meet
medication, you get the same for your deductible. Once you meet the deductible, you pay 20 percent
less—brand-name medications and
their generic equivalents contain the of the cost of prescriptions until you reach the out-of-pocket
same active ingredients, and are maximum.
often made by the same companies,
but the brand-name versions can be Under the POS plan, you pay the cost of prescription medications
many times more costly .
Tier II (generally consists of preferred until you reach the deductible. If the deductible is met, you then pay
brand-name medications): If you 20 percent of the cost of prescriptions until you reach the out-of-
use a Tier II medication, you pay a pocket maximum.
higher price than you would if you
had used a Tier I medication . A Tier II
medication is a patented prescription Prescriptions can be purchased from in-network retail pharmacies
that appears on the plan’s preferred or by mail order. The amount of your prescription depends on the
prescription list . Medications on this type of medication your doctor prescribes, and where you choose to
list are preferred by the plan for their
combination of safety, effectiveness purchase the prescription.
and cost .
Tier III (generally consists of non- Preventive Prescription Medications—No Cost
preferred brand-name medications): Under the HDP
If you use a non-preferred
medication, you pay a higher price Preventive prescription medications are covered at 100 percent
than Tier II . A Tier III medication does (in-network only) under the Thompson Coburn HDP . Preventive
not appear on the plan’s preferred prescription medications do not apply toward the deductible .
prescription medication list . This This allows HDP participants to receive preventive prescription
usually means that a generic or
preferred medication can be equally medications without having to meet the deductible . Visit TC
effective but at a lower cost . Connect for the list of preventive prescription medications .
2017 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 3-month supply You pay the discounted price of a 3-month supply
of a prescription medication until you reach the of a prescription medication until you reach the
combined medical/pharmacy deductible; after the combined medical/pharmacy deductible; after the
deductible is met, you pay 20% of the discounted deductible is met, you pay 20% of the discounted
price until the out-of-pocket maximum is met price until the out-of-pocket maximum is met
Preventive Prescription Medications
Covered 80% after deductible Covered at 100%
* In-network coverage only
8 Thompson Coburn LLP
Pharmacy Plans When you enroll in one of the Thompson Coburn medical plans,
you automatically receive coverage for prescription drugs at no
` additional premium.
Tier I (generally consists of generic
medication): If you use a generic The HDP requires you to pay the cost of your prescriptions (with
medication, you’ll typically pay a
lower price . When you use a generic the exception of preventive prescription medications) until you meet
medication, you get the same for your deductible. Once you meet the deductible, you pay 20 percent
less—brand-name medications and
their generic equivalents contain the of the cost of prescriptions until you reach the out-of-pocket
same active ingredients, and are maximum.
often made by the same companies,
but the brand-name versions can be Under the POS plan, you pay the cost of prescription medications
many times more costly .
Tier II (generally consists of preferred until you reach the deductible. If the deductible is met, you then pay
brand-name medications): If you 20 percent of the cost of prescriptions until you reach the out-of-
use a Tier II medication, you pay a pocket maximum.
higher price than you would if you
had used a Tier I medication . A Tier II
medication is a patented prescription Prescriptions can be purchased from in-network retail pharmacies
that appears on the plan’s preferred or by mail order. The amount of your prescription depends on the
prescription list . Medications on this type of medication your doctor prescribes, and where you choose to
list are preferred by the plan for their
combination of safety, effectiveness purchase the prescription.
and cost .
Tier III (generally consists of non- Preventive Prescription Medications—No Cost
preferred brand-name medications): Under the HDP
If you use a non-preferred
medication, you pay a higher price Preventive prescription medications are covered at 100 percent
than Tier II . A Tier III medication does (in-network only) under the Thompson Coburn HDP . Preventive
not appear on the plan’s preferred prescription medications do not apply toward the deductible .
prescription medication list . This This allows HDP participants to receive preventive prescription
usually means that a generic or
preferred medication can be equally medications without having to meet the deductible . Visit TC
effective but at a lower cost . Connect for the list of preventive prescription medications .
2017 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 3-month supply You pay the discounted price of a 3-month supply
of a prescription medication until you reach the of a prescription medication until you reach the
combined medical/pharmacy deductible; after the combined medical/pharmacy deductible; after the
deductible is met, you pay 20% of the discounted deductible is met, you pay 20% of the discounted
price until the out-of-pocket maximum is met price until the out-of-pocket maximum is met
Preventive Prescription Medications
Covered 80% after deductible Covered at 100%
* In-network coverage only
8 Thompson Coburn LLP
