Prescription drugs can be a major part of your healthcare needs – and they can also be a major expense. Both of our medical plans have excellent prescription drug coverage. Depending on your needs, you can get your prescriptions in a variety of ways to help offset the cost.

Save money on prescription drugs:

• Use generic drugs when possible – check with your doctor to see if generics may be appropriate for your personal situation.
• Ask for “preferred” brand-name drugs – when using a generic is not possible, ask your doctor if a preferred (formulary) brand-name drug may be used.
• Use mail-order for maintenance medications – your copay for a 90-day supply (Cigna) or 100-day supply (Kaiser) through mail-order is less than three copays at the pharmacy. Plus, you can enjoy the convenience of home (or office) delivery!
• Use your FSA or HSA. If you have a Flexible Spending Account or a Health Savings Account, you can purchase your prescriptions through these tax-saving tools.

What is a formulary?

A drug formulary is a list of prescription drugs covered by your medical plan. Separated into tiers, these groups range from least expensive to most expensive. “Preferred” drugs generally cost you less than “non-preferred” drugs.

To get the most out of your coverage, know where your prescriptions fall within your plan’s drug formulary and ask your doctor for advice.

More about generic drugs:

If a generic drug is available and you choose to purchase the brand-name medication instead, you will pay the formulary/brand-name copay plus the difference between the cost of the formulary/brand-name drug and the generic drug. Generics are required by the Food and Drug Administration (FDA) to perform the same as brand-name equivalents.

Why did the cost of my prescription change?

Prescription drugs are often categorized into three Tiers. Tier one is made up of the lowest costing generic drugs, Tier two is generally made of higher costing generic drug formulas that may include brand name ingredients, and Tier three is often mostly brand name drugs.

Most prescriptions fall under one of these tiers and the designations determine if a prescription is free, has a low copay, or has a high copay.

This means that insurance companies decide what prescriptions they will cover as long as the drugs on the list meet FDA standards. Formularies can also change often. For example, if you had a brand-name prescription with no generic equivalent, it must be covered and may be designated to a lower tier. But if a generic version of your prescription is added to the list, your current brand name prescription will likely move from a lower tier to a higher tier—resulting in the cost change.

What should I do if my prescription isn’t covered?

If your prescription is no longer covered or if the cost has changed, the first thing you should do is ask your insurance company for a list of the prescriptions they cover (the formulary) and what tiers they fall into since it’s possible your prescription moved to a different tier.

Once you have that list, you can talk to your doctor or health provider about possibly changing to a generic version of your drug. Your insurance provider may also be able to approve coverage for your current prescription based on their medical recommendations.

Review your prescription benefits within your medical plan:

Cigna Members

Cigna offers home delivery with Express Scripts Pharmacy so you can enjoy the convenience of having your medications delivered right to your door. You can even fill up to a 90-day supply, sign up for automatic refills, and get 24/7 access to pharmacists from your phone or computer.

Click here to get started.

Kaiser Members

When you are too busy to make it to the pharmacy, get your prescriptions delivered to your home with Kaiser’s Prescription Home Delivery. Sign up through your KP mobile app and find your pharmacy at your fingertips.

Find out more here.

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