Pharmacy benefits

Pharmacy benefits

TIH extends benefits coverage for generic and brand-name medications.

Pharmacy benefits carriers

2024

Aetna plans include prescription drug coverage through CVS Caremark. Kaiser Permanente has its own exclusive pharmacy benefits.

Teammates can fill their prescriptions at CVS and other participating pharmacies included in the Aetna Extended Day Supply Network.

 

Prescription drug tiers

Certain preventive medications are covered at 100% with no deductible required. In addition to preventive medications, for 2024, there are four benefit tiers for prescription drugs: 

  • Tier 1 – Generally contains generic drugs that are cost effective alternatives to brand name drugs
  • Tier 2 – Generally contains preferred brand name drugs that are chosen for their clinical value and cost effectiveness
  • Tier 3 – Generally contains non-preferred brand drugs
  • Tier 4 –Specialty drugs, such as gene therapies and biotechnological medications, and consists of the highest-cost prescription medications 

Prescription drugs

2024: What you pay

You’ll pay either a copay or a percentage of a drug’s cost at an in-network pharmacy, depending on your plan and the drug tier. There is no out-of-network coverage.

  $500 PPO
$1500 Upfront Advantage
$250 ACO		 $2,500 HDHP *
$4,000 HDHP
Preventive $0 $0
Retail    
Tier 1 - Generic $10 20% after deductable
Tier 2 - Preferred brand name $30
Tier 3 - Non-preferred brand name $70
Tier 4 - Specialty 20%
$50 min - $150 max ** 		20%**
Mail order    
Tier 1 - Generic $20 20% after deductable
Tier 2 - Preferred brand name $60
Tier 3 - Non-preferred brand name $140
Tier 4 - Specialty 20%
$50 min - $150 max ** 		20%**

*Kaiser $2,500 HDHP plan coverage is the same as the Aetna $2,500 HDHP coverage (PrudentRx doesn’t apply).

**If the drug is on the PrudentRx drug list: $0 copay if enrolled in PrudentRx; 30% coinsurance if not enrolled. 

Refill a prescription online or by mail

Scripta: Prescription drugs savings

Teammates have access to Scripta, a benefit that helps you save money.

  • Your prescriptions at the lowest cost: Scripta searches for the best prices to help you and your doctor choose the medications best for you.
  • Monthly savings reports: Scripta creates monthly, personalized savings reports that list lower-priced drug options and savings strategies. The suggested alternatives treat the same medical conditions as the medications you’re already taking. 
  • A helpful tool to discuss with your doctor: Doctors usually don’t know how much your medications cost. Scripta gives you and your doctor information to help decide which drugs are best for your health and your wallet.