J E Smith Employee Communication 2023

Pharmacy Benefits

Pharmacy Plan Details

Pharmacy Network

Standard Select

Prescription Drug List

Advantage

In Network

Annual Pharmacy Deductible

Individual

You do not have to pay a pharmacy deductible

Family

You do not have to pay a pharmacy deductible

Up to a 31-day supply

Up to a 90-day supply

Prescription Drug Product Tier Level

Mail Order Network Pharmacy**

Retail Network***

Out-of-Network Pharmacy

Tier 1 $ Tier 2 $$ Tier 3 $$$ Tier 4 $$$$

$10

$10

$25

$35

$35

$87.50

$75

$75

$187.50

$250

$250

$625

Mail Order Preferred Specialty Network Pharmacy**

Preferred Specialty Prescription Drug Product Tier Level

Preferred Specialty Retail Network

Preferred Specialty Out-of- Network Pharmacy

Tier 1 $ Tier 2 $$ Tier 3 $$$ Tier 4 $$$$

$10

$10

Not applicable

$150

$150

Not applicable

$350

$350

Not applicable

$500

$500

Not applicable

** Only certain Prescription Drug Products are available through mail order; please visit myuhc.com® or call Customer Care at the telephone number on the back of your ID card for more information. You will be charged a retail Copayment and/or Coinsurance for 31 days or 2 times for 60 days based on the number of days supply dispensed for any Prescription Order or Refills sent to the mail order pharmacy. To maximize your Benefit, ask your Physician to write your Prescription Order or Refill for a 90-day supply, with refills when appropriate, rather than a 30-day supply with three refills. ***Retail: up to a 90 day supply. You will be charged a retail Copayment and/or Coinsurance for 31 days, 2 times for 60 days, or 3 times for 90 days based on the number of days supply dispensed for any Prescription Order or Refills obtained at a retail pharmacy. Your Copayment and/or Coinsurance is determined by the tier to which the Prescription Drug List (PDL) Management Committee has assigned the Prescription Drug Product. All Prescription Drug Products on the Prescription Drug List are assigned to Tier 1, Tier 2, Tier 3 or Tier 4. If you are a member, you can find individualized information on your benefit coverage, determine tier status, check the status of claims and search for network pharmacies by logging into your account on myuhc.com® or calling the Customer Care number on your ID card. If you are not a member, you can view prescription information at welcometouhc.com > Benefits > Pharmacy Benefits.

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