Prescription Drugs
Prescription drug coverage is included in your medical plan.
Your cost to fill a prescription depends on three things:
- Which health care plan you are enrolled in
- The tier your drug is in (generic, preferred brand, non-preferred brand or specialty)
- Whether you obtain the drug at a retail pharmacy or through mail order
Understanding Prescription Drug Tiers
- Generic: In most cases, your cost is lowest when you select a drug from this tier. A generic is an affordable and effective alternative to a brand name drug.
- Preferred brand drugs: Drugs in this tier typically cost more than generics but less than other brand-name drugs because of their preferred status. Preferred brand drugs are chosen for their clinical value and cost-effectiveness.
- Non-preferred brand name drugs: Drugs in this tier are covered under the plan but cost more than a preferred brand drug would.
Retail vs. Mail Order Prescriptions
Typically, retail pharmacies are used for filling 30-day prescriptions. However, you may be able to order a 90-day supply of maintenance medications — either at a retail pharmacy or through mail order.
The advantage to using mail order for 90-day prescriptions is convenience—your prescription is delivered to your door with an auto-refill option. Plus, if you are enrolled in the PPO medical plan, you can receive a discount for using the mail order service!
No-Pay Copay for Asthma & Diabetes Medications
In the program, you’ll work one-on-one with a care manager to:
- Evaluate your wellness and personal needs
- Coordinate your health care
- Improve self-management of your condition
Call 800-557-6916 or email caremanagement@jhhp.org to learn more and enroll.
PrudentRx Specialty Medication Program
You can view the current list of eligible medications under the PrudentRx program. This list is updated monthly, so please check it regularly for any changes.
You’re automatically enrolled in the PrudentRx program if you take any eligible medications. If you choose to opt out of the program, you’ll pay 30% coinsurance (after the deductible) for your medication. View the FAQs for more information.
Note: If you contributed a certain amount to your Health Care Flexible spending Account (HCFSA) for 2024 based on your specialty medication’s eligibility, and it was added or dropped from the list for 2024, you will be allowed to make changes to your 2024 HCFSA election.