PRESCRIPTION DRUG BENEFITS
Your medical insurance includes comprehensive prescription drug coverage . The level of coverage depends on whether the drug is generic or brand name , and whether it is on the Optum Rx formulary , or preferred drug list . Your out-of-pocket cost is lowest when you buy generic drugs , and highest when you buy brand name drugs that are not on the formulary . To find out if your medication is on the formulary , please check the online list at www . optumrx . com .
Prescription Drug Plan
Annual Rx Out-of-Pocket Maximum ( Individual / Family )
Retail Pharmacy - up to 31-day supply
Generic Preferred Brand Non-Preferred Brand Specialty – up to 30-day supply
$ 1,600 / $ 3,200
At Participating Pharmacies Only
$ 10 $ 25 $ 40 Same as Retail Copays
Mail Order - up to 90-day supply $ 20 / $ 50 / $ 120
There are two ways to receive a 90-day supply of your medications : at retail or through mail order . Most of our members access this program through retail pharmacies . If you would like information about the mail order program , contact HMA at 800.869.7093
GOOD RX
Prices for prescription drugs vary widely between pharmacies . GoodRx is an easy-to-use website and mobile app , which compares prescription costs at near-by pharmacies .
� You may download the app or go to www . goodrx . com
Prepared by Gallagher for the Employees of The Suquamish Tribe 7