Pharmacy Benefits under the HDHP and PPO Plan Options
When you enroll in one of The Hartford’s health plan options, you automatically receive pharmacy benefits administered by OptumRx.® OptumRx provides a large network of pharmacies nationwide, including most large chains, and 90-day maintenance medication prescription refills are available at CVS pharmacies or via home delivery.
The Formulary has three Tiers based on cost, where the lower the Tier the lower the prescription drug cost. Brand name and generic medications, including specialty medications, can be found in any of the three Tiers. There is no minimum cost per prescription.
Take a look at what you can expect to pay at the pharmacy.
| Tier | Prescription | MyChoice Core and MyChoice Plus (HDHP) After annual deductible is met |
MyChoice Select (PPO) Not subject to an annual deductible |
| 1 | Lower cost, generics and some brand names | 20% | |
| Maximum Cost Per Prescription | |||
| 30-day ($25) 90-day ($50) |
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| 2 | Mid-range cost, preferred brand names | 20% | |
| Maximum Cost Per Prescription | |||
| 30-day ($60) 90-day ($120) |
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| 3 | Higher cost, non-preferred brand name, some generics and specialty | 20% | |
| Maximum Cost Per Prescription | |||
| 30-day ($125) 90-day ($250) |
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Drugs covered under the Formulary are evaluated, with changes made twice a year (January and July). When a medication is removed from the Formulary, or is moved to a more expensive Tier, OptumRx will notify you if you are impacted.
Drug costs may vary depending on the drug. Your doctor may be able to prescribe a lower cost alternative that is just as effective. Use the drug calculator available on www.OptumRx.com to help you and your doctor make an informed decision. Please note that some prescription drugs require prior authorization by OptumRx. Please check with your doctor or OptumRx if you have a question about your prescription and whether prior authorization is required.