Page 13 - Optima Tax EE Guide 01-19 AZ.pub

Prescription Drugs

The United Healthcare and Blue Shield medical plans include prescription drug coverage for you and your covered
dependents.

Retail Pharmacy
Use a retail pharmacy to fill prescriptions for acute conditions (conditions that do not
require the medication to be taken on a regular basis). At a participating pharmacy, you
will receive up to a 30 day supply of your prescriptions.

Mail Order Pharmacy – Maintenance Medication
You could pay less for the same medication when you use the mail order pharmacy.

The mail order pharmacy is a fast, easy and convenient way to save time and money on
your maintenance medications (drugs that you need to take regularly). You can order
additional supplies of medication at a discount. See below for details!

Plan Name United Healthcare Blue Shield Blue Shield
PPO Low
PPO High
HMO
Deductible $0 $0 $0 $0 $0
Retail Pharmacy
Tier 1a / 1b $15 $10 $10 + 25% $15 / $20 $15 + 25%
Tier 2 $45 $25 $25 + 25% $30 / $40 $30 + 25%
Tier 3 $90 $40 $40 + 25% $45 / $60 $45 + 25%
Supply Limit 30 Days 30 Days N/A 30 Days N/A
Mail Order Pharmacy
Tier 1 $37.50 $20 Not $30 Not
Tier 2 $112.50 $50 Covered $60 Covered
Tier 3 $225 $80 $90
Supply Limit 90 Days 90 Days N/A 90 Days N/A
Specialty - Retail & Mail Order
Specialty $350 Retail 30% Max $200 Not 30% Max $200 Not
$875 Mail Order Copay Covered Copay Covered
Supply Limit 30 /90 Days 30 Days N/A 30 Days N/A

Pharmacy Tips

Use generic and over the counter drugs when available.
The best way to save on prescriptions is to use generic or over the counter
medications as opposed to brand name drugs. Generic drugs must use the same
active ingredients as the brand name version of the drug. A generic drug must
also meet the same quality and safety standards.

Use the mail order benefit for maintenance medications
To save money and time, consider using the mail order pharmacy to fill your
maintenance medications.

Employee Benefits 13