Prescription drug
Your medication costs vary based on your medical plan and whether you use generic, preferred brand, non-preferred brand or specialty drugs and whether you fill your prescriptions with an in-network or out-of-network pharmacy. Using generic and preferred brands will ensure the best rates for your prescription needs.
If you enroll in medical coverage, you are automatically enrolled in prescription drug coverage.
Prescription drug program at a glance
| Plan features | HRA Plus | HSA Base | HRA Value | |||
|---|---|---|---|---|---|---|
| In-network | Out-of-network | In-network | Out-of-network | In-network | Out-of-network | |
| 30-day supply through retail or mail order | ||||||
| Preventive* | No copay | 50% after deductible | 0%, no deductible | 50% after deductible | No copay | 50% after deductible |
| Generic | $15 copay | 50% after deductible | 20% after deductible | 50% after deductible | $15 copay | 50% after deductible |
| Preferred brand | 30% up to $125 max | 50% after deductible | 30% after deductible (up to $125 max) |
50% after deductible | 30% up to $125 max | 50% after deductible |
| Non-preferred brand | 40% up to $225 max | 50% after deductible | 40% after deductible (up to $225 max) |
50% after deductible | 40% up to $225 max | 50% after deductible |
| Accredo Specialty Pharmacy | ||||||
| Specialty (limited to a 30-day supply) |
40% up to $225 max | 50% after deductible | 40% after deductible (up to $225 max) |
50% after deductible | 40% up to $225 max | 50% after deductible |
| 90-day supply through retail or mail order | ||||||
| Preventive | No copay | 50% after deductible | 0%, no deductible | 50% after deductible | No copay | 50% after deductible |
| Generic | $37 copay | 50% after deductible | 20% after deductible | 50% after deductible | $37 copay | 50% after deductible |
| Preferred brand | 30% up to $312 max | 50% after deductible | 30% after deductible (up to $312 max) | 50% after deductible | 30% up to $312 max | 50% after deductible |
| Non-preferred brand | 40% up to $562 max | 50% after deductible | 40% after deductible (up to $562 max) | 50% after deductible | 40% up to $562 max | 50% after deductible |
Generics first
Generic drugs usually cost less than brand name drugs.
Generic drugs are reviewed by the FDA to ensure that they work the same as the brand-name drug in dosage, safety, quality, performance, strength and usage.
To help keep prescription drug costs in check, prescriptions are automatically filled with a chemically equivalent generic drug, if available and appropriate. If you choose a brand drug when a generic is available, you will pay the difference between the brand medication and the generic, plus the coinsurance. However, if your doctor indicates “Dispense as Written” on your prescription because the brand is medically necessary, you will receive the brand drug and only pay the brand copay.
Note: If you choose a brand drug when a generic is available, you will pay the difference between the brand medication and the generic, plus the coinsurance.
Preferred brand drugs
Brand-name drugs on the preferred list are less expensive than using a non-preferred drug.
Non-preferred brand drugs
Brand-name drugs that are not on your preferred list may cost you more, even if they are recommended by your doctor.
Maintenance medications
Long-term medications, also known as maintenance drugs, are taken on a regular basis (three months or longer) to treat conditions such as high cholesterol, high blood pressure and asthma.
Maintenance medications are filled through Cigna 90 Now.
Specialty drugs
A specialty drug is a medication used to treat chronic, complex conditions like multiple sclerosis, hepatitis C and cancer. Specialty medications can include oral solids, or can be injected, infused or inhaled and may require special handling, such as refrigeration.
Preventive medications
There is no cost for medications on Cigna’s No Cost-Share Preventive Medication (ACA) list for all plan participants.
Additionally, for HSA Base Plan participants, when you purchase other preventive medications listed on Cigna’s 2022 Preventive Generics and Preferred Brands Drug list, you will pay 20% coinsurance, but no deductible applies.