Benefits

Pharmacy Benefits

The University's pharmacy benefit manager is now Premera, who partners with Express Scripts to provide pharmacy coverage at retail pharmacies and mail order.  Specialty medications are filled through Accredo Health Group or Walgreens Specialty Pharmacy.

Your Premera ID card will have all your pharmacy benefit information printed on it so when having a prescription filled after July 1, 2013, be sure to give your pharmacist your new ID card.

Pharmacy benefit information is available online at Premera.com.  Click on "Online Pharmacy" for more information.  You should log in to the Premera web site, then select "Pharmacy Services" under "My Premera Plan" to get the most detailed information about your benefits.

The University of Alaska uses a three-tiered benefit plan for the 750 Plan and High Deductible Plan (HDHP).  This means there are three tiers of copays:

  • Tier 1 drugs are generic,
  • Tier 2 are brand,
  • Tier 3 are non-preferred brand.

As a general rule, generics cost less; however, there ARE some individual cases where generics can cost a lot.  For a better understanding of your cost, you can sign up on the member portal and go to MyRxChoices.  When using the online drug search tool for these plans, use the B3 drug list.

The Consumer-Directed Health Plan (CDHP) treats prescription drugs like any other medical expense, subject to the deductible and coinsurance.  The drug list for this plan is A2 for the online search tool.

The CDHP also has preventive drug benefit that covers many medications at 100% with no deductible or coinsurance, like any other preventive medical service.  The drug list for this benefit is called the PV3 list, available here.

Once logged in to the Premera site, to find your drug, click on Rx Search, select the appropriate list (see above) and enter the name of the drug, or select the drug class to which it belongs.

To see the list of drugs requiring Step Therapy, Prior Authorization (PA) or have Quality Limits (QL), click on the link to view drugs that require prior authorization.

To see how much your drug costs (important for members on the CDHP), click on "compare prescription costs."  You must be logged in to do this, and you'll be directed to a link to "Visit MyPharmacyPlus", the Express Scripts price comparison tool called My Rx Choices.

 

When available, a generic drug will be dispensed in place of a brand name drug.  In the event a generic equivalent is not manufactured, the brand name copayment will apply.

If you or your doctor request a brand name drug when a generic equivalent is allowed by law and available, in addition to the brand name copayment you will be required to pay the difference in price between the brand name and the generic equivalent.

Mail Order Pharmacy

If you take certain medications on an ongoing basis, you can save money and time by having those medications filled by Express Scripts Home Delivery.  You can get up to a 90 day supply of your medication which eliminates trips to the pharmacy and saves you time and money.

Click here to get started today.

Once you get your mail order presciption established, refills are easily ordered online through Express Scripts' MyPharmacyPlus, or call Express Scripts at 800-391-9701.

Maintenance Medications

If you take a drug on a regular basis to control or treat an ongoing or chronic condition, you will be able to get your first two fills at a retail pharmacy but then will need to use the mail order pharmacy for future refills.  The first two fills at retail gives you time to get your mail order prescriptions established with Express Scripts.  If you don't use the mail order pharmacy for your maintenance drugs, the regular retail copay will be doubled for the same 30 day supply.  It really pays to use mail order for these medications.

Here is the list of Maintenance Medications.  Medications that can be damaged by freezing temperatures are exempt from the mail order requirement, and a current list of those exceptions can be found here.

Specialty Pharmacy

Specialty pharmacy is for members who require high cost "specialty" medications that are usually self-injected and used to treat complex or rare conditions such as multiple sclerosis, rheumatoid arthritis, hepatitis C, hemophilia and more.  Please use this link for more information on specialty drugs and how to use the Specialty Pharmacy service.

Pharmacy Coverage

 750 Plan and HDHPCDHP

Network Pharmacy - 30 day

supply

$5 copay for generic

$25 copay for brand

$50 copay for non-preferred brand

20% after deductible

20% after deductible

20% after deductible

Home Delivery - 90 day

supply

$10 copay for generic

$50 copay for brand

$100 copay for non-preferred brand

20% after deductible

20% after deductible

20% after deductible

Non-Network Pharmacy

(amounts over the negotiated

price are not subject to the

out-of-pocket maximum)

Pay retail price at time of purchase,

submit claim form to be

reimbursed at negotiated price

less appropriate copayment

Pay retail price at time of

purchase, submit a claim to

have negotiated price applied

to deductible or coinsurance,

as appropriate

All UA Choice pharmacy benefits subject to negotiated price limits

Back to Top