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.
PPO 750
HDHP HSA 2500
HDHP HRA 4000
In-network
In-network
In-network
Retail (30-Day Supply)
Generic (Tier 1)
$15 copay
$15 copay after deductible
$15 copay
Preferred Brand Name (Tier 2)
$35 copay
$35 copay after deductible
$35 copay
Non-Preferred (Tier 3)
$60 copay
$60 copay after deductible
$60 copay
Mail Order (90-Day Supply)*
Generic (Tier 1)
$37.50 copay
$37.50 copay
after deductible
$37.50 copay
Preferred Brand Name (Tier 2)
$87.50 copay
$87.50 copay
after deductible
$87.50 copay
Non-Preferred (Tier 3)
$150 copay
$150 copay
after deductible
$150 copay
Specialty
20% coinsurance
(up to $200)
20% after deductible (up to $200)
20% coinsurance
(up to $200)
*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.
OptumRx and CVS Pharmacy make it easy to get your medications and save money! The CVS90 Saver program allows you to get 90-day supplies of your maintenance medication through CVS or OptumRx Mail Order.
Transfer a prescription to CVS, visit here.
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