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Health Insurance, continued About Your Medical Plan’s Prescription Drug Coverage If you take any medications regularly, prescription drug costs can add up to a signi昀椀cant part of your overall health care expenses. Knowing how your medical plan’s prescription drug coverage works and what to do to manage costs can help you make smarter purchases and lower your out-of-pocket costs. Here are a few items that are important to note: › Under the Network Plan, lower Tier 1 copays for generic or brand drug 昀椀lls ($10 copay for formulary generic drugs and $40 copay for formulary brand drugs) will apply when having prescriptions 昀椀lled at a UnityPoint Health or Hy-Vee pharmacy. In addition, Tier 1 copays will apply to any retail pharmacy located outside a 15 mile radius of a UnityPoint Health or Hy-Vee pharmacy. › Please note, to further support our rural communities and those with limited access to a UnityPoint Health or Hy-Vee pharmacy, the lower Tier 1 copays explained above will apply to a few additional pharmacies. For a full list, please click here. › Under the Network Plan, higher Tier 2 copays for generic or brand drug 昀椀lls ($20 copay for formulary generic drugs and $50 copay for formulary brand drugs) will apply when having prescriptions 昀椀lled at any retail pharmacy located within a 15 mile radius of a UnityPoint Health or Hy-Vee pharmacy. › Both medical plans only provide coverage for formulary drugs. The formulary is compiled by a group of doctors and pharmacists. Medications are reviewed and approved for the formulary based on medical effectiveness and cost, which helps keep costs affordable for you. If you’d like to check to see if your prescriptions are on the formulary list, head to healthpartnersunitypointhealth.com/uph and click “Check Prescriptions.” › Coverage at CVS pharmacies (including Target locations) is not provided. › The Rx shopping tool is an online prescription cost- saving tool. It helps you 昀椀nd the lowest cost for medicines, based on your current health plan. Visit healthpartnersunitypointhealth.com/uph and log on to your myHealthPartners account. Once logged on, you’ll be able to use the Rx shopping tool. › A UnityPoint Health Medication Therapy Management (MTM) pharmacist can help you focus on your medicines to make sure they are a good 昀椀t for you and your health conditions. Your personal pharmacist will work with you and your care team to check that your medicines, doses, and schedules meet your needs. Your pharmacist will also make sure that your drugs work well together and aren’t causing side effects. Visits can often be provided by phone or video conference, making them easier to 昀椀t into your schedule. Working with a pharmacist on a regular basis might also save you money on your medicine copays. | 11 |

May 2024 | UPC Physicians Benefit Guide - Page 13 May 2024 | UPC Physicians Benefit Guide Page 12 Page 14