All medical plan participants receive prescription drug coverage through Optum Rx, the leading pharmacy provider in service and affordability.
Utilize the Optum Rx app to manage your prescriptions, price a drug, and search for network pharmacies.
HPN Solutions HMO
SHL Solutions PPO
SHL Solutions HSA PPO
In-network
In-network
Out-of-network
In-network
Out-of-network
Retail (30-Day Supply)
Prescription Drug Deductible
N/A
N/A
N/A
Included in medical deductible
Generic (Tier 1)
$25 copay
$25 copay
30%*
0% after
deductible
0% after
deductible
Preferred Brand Name (Tier 2)
$50 copay
$50 copay
30%*
0% after
deductible
0% after
deductible
Non-Preferred (Tier 3)
$75 copay
$75 copay
30%*
0% after
deductible
0% after
deductible
Mail Order (90-Day Supply)*
Generic (Tier 1)
$62.50 copay
$62.50 copay
30%*
0% after
deductible
No coverage
Preferred Brand Name (Tier 2)
$125 copay
$125 copay
30%*
0% after
deductible
No coverage
Non-Preferred (Tier 3)
$187.50 copay
$187.50 copay
30%*
0% after
deductible
No coverage
Specialty
Applicable tier copay
Applicable tier copay
N/A
0% after
deductible
No coverage
*The Mail Order (90-day supply) copays will also apply to 90-day supply retail prescriptions from a network pharmacy. After two grace fills, members will be required to fill 90-day maintenance prescriptions at CVS or use Optum mail-order.
Optum Rx provides you a variety of online tools to help manage your prescription drug needs including:
Visit optumrx.com to register your account using your member ID card.
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