Please view the prescription drug co-payment information and coverage schedule for your drug plan. You can confirm your drug plan type by referring to your member ID card, asking your Plan Administrator, or contacting HMAA.
If there is a generic equivalent available and a brand name (preferred or non-preferred) drug is dispensed, you may be responsible for the respective brand co-payment plus the cost difference between the generic and brand name drug.
The amount you pay for a covered drug will depend on your coverage tier. Each covered drug is in one of several tiers. Each drug’s tier amount may be different. Each drug tier may have a different copayment or coinsurance amount. Please refer to your Drug Certificate (“DRC”) for additional information. To find out the cost of your drugs, you may contact OptumRx toll-free at 1-800-880-1188.
In your prescription plan, the formulary drug list is used as a guide for determining your co-payment for each prescription, with drugs listed on the formulary typically available at a lower co-payment. However, only you and your doctor can decide which medications are right for you.
For HMAA’s current drug formulary developed by our pharmacy benefit manager, OptumRx, please view the Formulary Drug List.
Review the list carefully, and note it is not all-inclusive and is subject to change.
You can request convenient, cost-effective delivery of prescription drugs right to your door through OptumRx home delivery service. You can register online and submit orders 24 hours a day, 7 days a week from the OptumRx member portal or via their mobile app, or you may print and complete the Mail Order Prescription Form.
With our Step Therapy Program, you can receive the most cost-effective covered medications for various drug categories as early as possible in your treatment plan.
Effective January 1, 2019, a Quantity Limits Program will continue through OptumRx. An enhanced Step Therapy Program will begin July 1, 2019.