UVA HealthyRx Program Discontinues Reduced Member Drug Cost Sharing

Posted: October 4, 2018

The UVA Health Plan’s HealthyRx program will discontinue reduced member drug cost sharing on December 31, 2018. With the end of the program, some of your drug costs may increase to the cost sharing amounts detailed in the Plan’s Summary of Benefits. The prescription cost sharing amounts from the summaries are detailed below.

There are several opportunities for you to pursue low-cost options for prescription drugs in the absence of the HealthyRx program:

• The UVA Pharmacy is able to purchase drugs at a reduced government-program price, which results in a reduced cost to you since the drug cost sharing is a percentage of the cost of the drug. If the drug cost to the UVA Pharmacy is less than the cost of the same drug to other pharmacies, your percentage of the cost will also be less. In addition, there is no minimum cost sharing when you use the UVA Pharmacy. Prescriptions for tier 2 or tier 3 drugs filled at any other pharmacy require a minimum charge to the participant.

• Cost savings are available when you order scripts for chronic conditions through OptumRx’s mail order pharmacy. Visit their website at www.optumrx.com or contact them at 1.877.629.3123.

• Use OptumRx’s drug pricing tool which allows you to search for lower-cost pharmacy pricing options near you. Visit their website at www.optumrx.com.

You can also open a full Flexible Spending Account (FSA) if you are enrolled in Choice or Value Health and pay for your prescription using pre-tax dollars. If you are enrolled in Basic Health, you can use this tax-free option when you open a Limited Flexible Spending Account (LMT) or a Health Savings Account (HSA). These options will make your money go further than using after-tax dollars. You can only open these spending accounts during the Annual Enrollment Period, which runs from October 8 through October 19, 2018. The savings account can be opened anytime during the year. Information on these accounts is available on the Annual Enrollment webpages at www.hr.virginia.edu/ae.

If you have any questions regarding your pharmacy coverage, please call OptumRx Member Services Department at 1.877.629.3123. Representatives are available 24 hours a day, seven days a week to assist you.

Prescription Cost sharing for non-specialty drugs for Choice Health and Value Health Participants:

• Retail Pharmacy Network, participating pharmacies, 30-day supply: Tier 1 - $6; Tier 2 – deductible & 20% with $30 min/$125 max; Tier 3 – deductible & 20% with $60 min/$175 max

• UVA Pharmacy, 30-day supply: Tier 1 - $6; Tier 2 – deductible & 20% with $125 max; Tier 3 – deductible & 20% with $175 max

• OptumRx Home Delivery, 90-day supply: Tier 1 - $14; Tier 2 – 15% with $60 min/$325 max; Tier 3 - $15% with $120 min/$375 max

Prescription Cost sharing for non-specialty drugs for Basic Health Participants:

• All participating pharmacies, including UVA Pharmacy and OptumRx Home Delivery: deductible & 20%.