• There are no additional premiums for this plan; coverage is included with your medical plan. 
• The formulary has three tiers that provide a different level of coverage. A product covered at the highest level is available in every therapeutic class.
• Mail order is available at a reduced cost.
• Certain prevention prescriptions and contraceptives are covered at 100%, including  generic, preferred brand drugs, and some over-the-counter (OTC) drugs (prescription required).
• The OptumRx mobile app provides easy, on-the-go access to a member’s personalized health information and prescriptions.
• Members are required to create a HealthSafe ID when creating an online account. This ID number allows members to securely access their prescription and personal information with OptumRx.
• Over-the-counter (OTC) at-home diagnostic COVID-19 tests will be covered at a copay of $5 per test if purchased through OptumRx or an in-network pharmacy. Up to four tests per member, per month will be covered. For example, if you purchase a kit with two tests, the copay will be $10. If an OTC at-home COVID-19 test is purchased out-of-network, OptumRx will provide a reimbursement of up to $5 per test, up to four tests per member, per month. Deductible applies for those enrolled in the CDHP. 

To minimize costs, consider the following:

• Participants taking certain prescriptions on a monthly basis can purchase a three-month supply through mail order at the same cost as a two-month supply at retail. Home delivery provides automatic refills of medication. Contact OptumRx to make arrangements or complete the mail order form.
• If a prescription is not a generic or preferred medication on the formulary, contact OptumRx to find the best way to minimize costs.