Prescriptions
Looking after your health is important, which is why comprehensive and affordable prescriptions coverage is included in all of our plans. We offer three Medical plans through Cigna and Prescriptions coverage is administered by Express Scripts.
If you are enrolled in the HDHP Silver or HDHP Gold you can use a Health Savings Account to pay for prescriptions. Read more about Health Savings Account (HSA).
If you or your dependents have Medicare or will become eligible for Medicare in the next 12 months, a federal law gives you more choices about your Prescriptions coverage. To review the Medicare Part D notice, please review the Legal Notice.
How does it work?
You can choose between the HDHP Silver, the HDHP Gold and the Core Plan (read more about the Medical plans). The way you pay for prescriptions is different with each plan:
- Core
- You pay a set dollar amount (copay) for all prescriptions during the plan year.
- HDHP Silver
- You pay the full negotiated cost for prescriptions until you meet your annual deductible. Once you’ve met your annual deductible the plan pays for 100% of covered prescriptions for the rest of the year. You can use the dollars in your Health Savings Account (HSA) to pay for prescriptions.
- HDHP Gold
- You pay the full negotiated cost for prescriptions until you meet your annual deductible. Once you’ve met your annual deductible you and the plan both pay a portion of the cost for prescriptions (coinsurance) until you reach your annual out-of-pocket maximum. After that, the plan pays for 100% of covered prescriptions for the rest of the year. You can use the dollars in your Health Savings Account (HSA) to pay for prescriptions.
Choosing prescription drugs
You save dollars when you choose in-network pharmacies and generic drugs.
Generic drugs
Generic drugs are FDA-approved, and shown to be just as safe and effective as their more expensive brand-name counterparts. If you choose a brand-name drug when a generic drug is available, you will pay the brand-name copay and/or coinsurance plus the cost difference between the generic equivalent and the brand-name drug.
Preferred drugs
Cigna regularly reviews the latest prescription drugs on the market and maintains a list of preferred drugs that are clinically effective and not cost restrictive. These drugs are available at a lower price than those not included on the list, which are called non-preferred drugs.
Specialty drugs
Specialty drugs are typically used to treat chronic conditions, like cancer or multiple sclerosis. These drugs tend to be more expensive and usually require special handling and monitoring. If you take a specialty drug, you must utilize Cigna’s mail-order pharmacy. You can register for mail-order pharmacy by logging on to my.cigna.com.
What am I covered for?
| Summary of features | Core Plan | HDHP Silver | HDHP Gold | HDHP Gold |
|---|---|---|---|---|
| Network coverage * | In network only | In network only | In network | Out of network |
| Annual deductible (individual/family) - the out-of-pocket amount you have to pay before the plan starts paying coinsurance |
$2,500/$5,000 | $6,000/$12,000 | $3,200/$6,000 | $9,000/$18,000 |
| Annual out-of-pocket maximum (individual/family) - the most you have to pay for covered services during the plan year; after that, the plan pays the rest. |
$5,000/$10,000 | $6,000/$12,000 | $6,000/$12,000 | $18,000/$36,000 |
| Network coverage * | |
|---|---|
| Core Plan | In network only |
| HDHP Silver | In network only |
| HDHP Gold | In network |
| HDHP Gold | Out of network |
| Annual deductible (individual/family) - the out-of-pocket amount you have to pay before the plan starts paying coinsurance |
|
| Core Plan | $2,500/$5,000 |
| HDHP Silver | $6,000/$12,000 |
| HDHP Gold | $3,200/$6,000 |
| HDHP Gold | $9,000/$18,000 |
| Annual out-of-pocket maximum (individual/family) - the most you have to pay for covered services during the plan year; after that, the plan pays the rest. |
|
| Core Plan | $5,000/$10,000 |
| HDHP Silver | $6,000/$12,000 |
| HDHP Gold | $6,000/$12,000 |
| HDHP Gold | $18,000/$36,000 |
Prescriptions — retail (30-day supply):
| Summary of features | Core Plan | HDHP Silver | HDHP Gold |
|---|---|---|---|
| Generic drugs | $15 copay ** | 0% after annual deductible | 20% after annual deductible |
| Preferred drugs | $35 copay ** | 0% after annual deductible | 20% after annual deductible |
| Non-preferred drugs | $50 copay ** | 0% after annual deductible | 20% after annual deductible |
| Specialty drugs | $250 copay ** | 0% after annual deductible | 20% after annual deductible |
| Generic drugs | |
|---|---|
| Core Plan | $15 copay ** |
| HDHP Silver | 0% after annual deductible |
| HDHP Gold | 20% after annual deductible |
| Preferred drugs | |
| Core Plan | $35 copay ** |
| HDHP Silver | 0% after annual deductible |
| HDHP Gold | 20% after annual deductible |
| Non-preferred drugs | |
| Core Plan | $50 copay ** |
| HDHP Silver | 0% after annual deductible |
| HDHP Gold | 20% after annual deductible |
| Specialty drugs | |
| Core Plan | $250 copay ** |
| HDHP Silver | 0% after annual deductible |
| HDHP Gold | 20% after annual deductible |
Prescriptions — mail-order (90-day supply):
| Summary of features | Core Plan | HDHP Silver | HDHP Gold |
|---|---|---|---|
| Generic drugs | $30 copay ** | 0% after annual deductible | 20% after annual deductible |
| Preferred drugs | $70 copay ** | 0% after annual deductible | 20% after annual deductible |
| Non-preferred drugs | $100 copay ** | 0% after annual deductible | 20% after annual deductible |
| Specialty drugs | N/A | 0% after annual deductible | 20% after annual deductible |
| Generic drugs | |
|---|---|
| Core Plan | $30 copay ** |
| HDHP Silver | 0% after annual deductible |
| HDHP Gold | 20% after annual deductible |
| Preferred drugs | |
| Core Plan | $70 copay ** |
| HDHP Silver | 0% after annual deductible |
| HDHP Gold | 20% after annual deductible |
| Non-preferred drugs | |
| Core Plan | $100 copay ** |
| HDHP Silver | 0% after annual deductible |
| HDHP Gold | 20% after annual deductible |
| Specialty drugs | |
| Core Plan | N/A |
| HDHP Silver | 0% after annual deductible |
| HDHP Gold | 20% after annual deductible |
* Network - the facilities and providers the medical plan has contracted with to provide services. In-network providers typically provide services at a lower negotiated rate.
** Copay - a set dollar amount you pay for a service, usually when you receive the service.
How much will coverage cost me?
Coverage is included under your Medical plan.
How do I find a pharmacy?
Visit my.cigna.com or call 800.513.1667 to find pharmacies in the Cigna Open Access Plus network.
When asked for your Group Number, please provide the number 3339897.
Remember, you save dollars when you choose an in-network pharmacy.
Healthcare concierge
If you need help choosing a provider, Alight Solutions gives you access to a personal Health Pro® consultant who can assist you and your family with:
- Understanding your benefits
- Finding highly-rated doctors, dentists and eye care professionals
- Saving money by comparing prices for you and helping you to choose more cost-effective options
- Paying less for prescriptions, by recommending lower-cost prescription drugs
- Resolving billing errors
- Scheduling appointments, at times most convenient for you
To use this service, complete your health profile at member.alight.com and call 800.513.1667 to get assistance.
To review the Medicare Part D notice, please review the Legal Notice.