Pharmacy Resource Guide – Section 8

Making smart choices will save you money on your prescriptions. Here are some easy ways to maximize your pharmacy benefit today.

1. Ask your doctor or pharmacist for a medication in the lowest tier on the prescription drug formulary or a “biosimilar.” (These work just as well as expensive brand-name drugs but cost much less.)

   • When you’re filling a new medication or getting a refill, ask your provider or pharmacist if there is a lower-cost equivalent, using the formulary.
   • Learn how to read your formulary so you are prepared to talk with your doctor or pharmacist about your options.

2. HSA Advantage Plan members can save on some medications used for chronic conditions.

   • Many maintenance medications used to treat or reduce the risk of chronic conditions (such as insulin) are on the preventive drug list.
   • For these, HSA Advantage Plan members pay the Signature Plan copay, which is typically lower than the deductible plus coinsurance.
   • While these copays do not apply to the HSA Advantage Plan deductible, they do apply to the out-of-pocket maximum.

3. Manufacturer assistance coupon card programs.

   • Check the manufacturer’s website to see if discounts are available.
   • Manufacturers may change the amount offered by their assistance programs at any time. For some specialty and high-cost medications, our pharmacy team may ask you to enroll in a manufacturer assistance coupon card program. We encourage you to use these programs, which are set up by drug companies to help reduce your out-of-pocket costs. The pharmacy team will assist you in this process.
   • The amount paid by the manufacturer will not apply to your deductible or out-of-pocket maximum.
   • If you receive a manufacturer copay or discount card after your prescription is approved, please call the pharmacy or send the card information (specifically the member ID, group number, PCN, and BIN) through MyChart.

4. Use pretax dollars to pay medication costs.

   • Members of the HSA Advantage Plan can use funds from their Health Savings Account. This allows you to use pretax dollars, as well as the health system’s contribution, to help pay for your medications until you meet your deductible and, after that, for your coinsurance amount.
   • Members of the Signature Plan can sign up for a Healthcare Flexible Spending Account during annual benefits enrollment and use these pretax dollars to pay for their medications and other healthcare costs.