Page 10 - GESMN 2019 Benefits Enrollment Guide

What About My

Prescriptions? Paying for Services
You may fill your prescriptions at In addition to sharing the monthly premium cost with GESMN, you share in the
one of HealthPartners’ more than
66,000 pharmacies nationwide or cost of services you receive, as follows.
through the convenient and cost
effective mail order program. An
important part of your pharmacy High Deductible Plans
benefits is HealthPartners’
preferred drug list (PDL). All Annual Deductible and Out-of-Pocket Maximum
medical plan options will include
the GenericsAdvantageRx
Formulary. This list contains With the $2,700 deductible plan with HSA, you pay the first $2,700 of covered
both brand-name and generic expenses for each individual and a maximum of $5,400 for your family. The
drugs with proven safety and
effectiveness. Medications on the annual deductible is equal to the out-of-pocket maximum.
PDL are placed into tiers. These
tiers determine your out-of- Under the $3,000 deductible plan with HSA, you will pay the first $3,000 of
pocket costs.
covered expenses for each individual and a maximum of $6,000 for your family.
• For information about your
specific coverage and costs,
log in to
healthpartners.com or call Coinsurance
members services Under the $2,700 deductible with HSA plan, once you meet the annual deductible,

• For questions concerning the plan pays 100% of the cost.
prior authorization or step
therapy, please contact
the Rx Navigator via Under the $3,000 deductible HSA plan, once you meet the deductible, you and
HealthPartners’ member the plan will share costs through coinsurance of 80% until you reach the out-of-
services
pocket maximum.

Out-of-Pocket Maximum

The amount you must pay out of your own pocket for your annual deductible,
copayments and coinsurance is limited each plan year. This limit is called the out-
of-pocket maximum. The out-of-pocket maximum for the $3,000 deductible with
HSA plan is $6,000 for each individual and $12,000 per family.

Health Savings Account (HSA)

You may choose to use funds from your HSA to offset the deductible. See the next

section for more details on the HSA.

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