MedImpact is the prescription drug administrator for all three medical plans. MedImpact offers a nationwide network of national chain pharmacies and independent pharmacies. The amount you pay for covered prescription drugs depends on the medical plan in which you’re enrolled, the type of prescription and if you’ve met your plan’s annual deductible or out-of-pocket maximum.
Your pharmacy benefits are included on your medical card. There is not a separate card for pharmacy benefits.
Prescription Drug Coverage
Here’s how much you’ll pay for prescription drugs under each medical plan at a retail pharmacy (up to a 30-day supply):
Health Savings Plan
Tier 1: 10% after deductible
Tier 2: 10% after deductible
Tier 3: 10% after deductible
Tier 1: $18 copay
Tier 2: $62 copay
Tier 3: $97 copay
Tier 1: $14 copay
Tier 2: $57 copay
Tier 3: $92 copay
Considering Which Plan to Choose?
Check the prescription drug formulary to see how your medications are covered under each plan and in-network pharmacies where those medications are available.
Prescription Drug Formulary
A formulary shows the medications covered under your health plan, how much they cost, and any limitations.
Medications on the formulary are categorized into tiers:
Tier 1: Generic drugs. These are the lowest-cost option. These drugs are FDA approved and have the same active ingredients as their brand-name equivalents. Their cost is lower because they are produced by a generic manufacturer.
Tier 2: Preferred brand-name drugs. These are a higher-cost option. These drugs are the original brand-name drugs that have no cheaper, generic equivalent currently available; however, they are still cost effective compared to alternate options.
Tier 3: Non-preferred drugs. These are the drugs that will cost you the most out of pocket. Non-preferred brand-name drugs in this tier often have a generic or preferred drug equivalent with lower-cost options available. Brand medications are not covered if a lower-cost option is available on Tier 1 or Tier 2.
Limitations listed on a formulary could include:
Step therapy: You’ll be required to try an alternative medication before the one you requested will be covered.
Prior authorization: The plan must approve your use of this medication before it will be covered.
Quantity limit: This medication has a limit to how much can be filled at one time.
MedImpact Direct Specialty Program
With the MedImpact Direct Specialty Program (MIDS), it’s not just about your medication — it’s about the entire specialty drug process. MIDS provides you with clinical consultations and support to ensure you understand how to take your medication, potential side effects, and more.
Specialty drugs are generally high-cost prescription medications taken for a complicated illness. Not all specialty medications are included in the program. Currently, the program focuses on oncology medications and highly utilized specialty medications.
Specialty medications that are covered by the MIDS program are only available through specialty pharmacies at UAMS, Kroger and US Bioservices.
For prior authorization requests, please contact EBRx:
Save on Medications
Here are tips on how to spend less on prescription drugs without compromising quality, safety or effectiveness:
Ask for generics. They’re usually much less expensive than brand name drugs. According to the FDA (the U.S. Food and Drug Administration), a generic drug is identical — or “bioequivalent” — to a brand name drug in dosage form, safety, strength, route of administration, quality, performance characteristics and intended use.
Visit MedImpact for Rx tools and resources. Sign in for access to:
Drug information. Search drugs, check drug interactions and identify pills.
Benefit highlights. See your copay amounts and other pharmacy benefit information.
Drug price check. Make informed drug choices and compare drug prices.
Pharmacy locator. Find a participating network pharmacy near you.
PersonalHealth Rx® . Print your drug history for a physician visit or tax reporting.
Microsoft® HealthVault™. Upload your prescription claims to your Microsoft HealthVault account.
Try mail order for maintenance medication. Order up to 90 days of medication at a time for drugs taken for long periods, through Birdi, MedImpact’s mail order service. Medications are sent to your home with no shipping fee.
When you purchase an insulin pump, it will be covered under the medical plan — not under prescription drug coverage. Continuous glucose monitors will only be covered under the pharmacy benefit. The preferred brands for continuous glucose monitors are FreeStyle Libre and Dexcom G6.
Diabetes supplies will continue to be covered under both the medical and pharmacy benefit.