The prescription benefit is the same for all UK health plans, except the UK Health Saver plan, which pays a percentage of prescription costs after you meet your deductible. You are automatically enrolled in prescription coverage if you are enrolled on one of our health plans.
Express Scripts is our benefit manager for prescription coverage.
Sometimes medicines can change categories (generic, preferred brand, non-preferred brand). It's always a good idea to check which category your medicine is in. To view this information, visit www.express-scripts.com. Questions? Please call our pharmacists with the Know Your Rx Coalition at (859) 218-5979 or (855) 218-5979 for information specific to your medication, formulary and costs.
Receive a 90-day supply for each prescription through Express Scripts Mail Service Pharmacy or a UK Retail Pharmacy (such as the one at Kentucky Clinic) to get the 90-day supply discount. For example, UK Retail Pharmacies offer UK employees enrolled in a UK health plan a 50 percent discount (up to $60) on many medicines if they are prescribed by a UK HealthCare provider.
Below is an example of how choosing where and how to fill your prescription can save you - and the University - money on your medicines.
Mike visits his UK HealthCare doctor and gets a prescription for a beta blocker for his high blood pressure. Mike asks his doctor to prescribe a 90-day supply of the generic medicine. Because Mike sees a UK doctor and fills his prescription at a UK Retail Pharmacy, he receives a 50 percent discount.
Total cost of 90-day supply: $26.37
Mike pays his $12 minimum co-pay for a 90-day generic supply at Kentucky Clinic Pharmacy (including his 50 percent discount).
UK pays $14.37.
Ike goes to his non-UK HealthCare doctor and also finds he needs a beta blocker for high blood pressure. Ike receives a prescription for a 90-day supply of the brand-name medicine, which Ike fills through the Express Scripts mail order pharmacy.
Total cost of 90-day supply: $322.99
Ike pays his $120 minimum co-pay for a 90-day brand-name supply.
UK pays $202.99.
Co-insurance and copays per prescription
Health plan members
30-day prescriptions 30-day supply or less
| Category | You'll pay |
|---|---|
| Generic | 20% (minimum of $8 to maximum of $50) |
| Formulary brand | 40% (minimum of $20 to maximum of $60) |
| Non-formulary brand | 50% (minimum of $40 and no maximum) |
| Speciality generic | 20% (minimum of $8 to maximum of $50) |
| Speciality brand* | $200 |
| Category | You'll pay (before deductible) | You'll pay (after deductible) |
|---|---|---|
| Generic | Before your annual deductible is met, you'll pay 100% of the cost of your prescriptions. | 20% |
| Formulary brand | 40% | |
| Non-formulary brand | 50% | |
| Speciality generic | 20% | |
| Speciality brand* | 50% |
90-day prescriptions 31- to 90-day supply (UK pharmacies and Express Scripts)
| Category | You'll pay |
|---|---|
| Generic | 10% (minimum of $24 to maximum of $100) |
| Formulary brand | 30% (minimum of $60 to maximum of $120) |
| Non-formulary brand | 40% (minimum of $120 and no maximum) |
| Speciality generic | N/A (limited to 30 days) |
| Speciality brand* | N/A (limited to 30 days) |
| Category | You'll pay (before deductible) | You'll pay (after deductible) |
|---|---|---|
| Generic | Before your annual deductible is met, you'll pay 100% of the cost of your prescriptions. | 20% |
| Formulary brand | 40% | |
| Non-formulary brand | 50% | |
| Speciality generic | N/A (limited to 30 days) | |
| Speciality brand* | N/A (limited to 30 days) |
*Certain specialty medications are considered non-essential health benefits under the plan. Co-pays for these specialty medications will be set to the maximum of current plan design or any available manufacturer-funded copay assistance. Program drugs will be reimbursed by the manufacturer at no cost to the participant. The cost of such drugs will not be applied toward participants prescription out of pocket. A list of included specialty medications available here.
Medicare
30-day prescriptions 30-day supply or less
| Category | You'll pay |
|---|---|
| Generic | 20% (no minimum to maximum of $50) |
| Preferred brand | 40% (minimum of $20 to maximum of $60) |
| Non-preferred (includes some generics) | 50% (minimum of $40 and no maximum) |
| Non-formulary generic/brand | Not covered |
60-day prescriptions 31- to 60-day supply
| Category | You'll pay |
|---|---|
| Generic | 10% (minimum of $24 to maximum of $100) |
| Preferred brand | 30% (minimum of $60 to maximum of $120) |
| Non-preferred (includes some generics) | 40% (minimum of $120 and no maximum) |
| Non-formulary generic/brand | Not covered |
| Category | You'll pay |
|---|---|
| Generic | 20% (no minimum to maximum of $100) |
| Preferred brand | 40% (minimum of $40 to maximum $120) |
| Non-preferred (includes some generics) | 50% (minimum of $80 and no maximum) |
| Non-formulary generic/brand | Not covered |
90-day prescriptions 61- to 90-day supply
| Category | You'll pay |
|---|---|
| Generic | 10% (minimum of $24 to maximum of $100) |
| Preferred brand | 30% (minimum of $60 to maximum of $120) |
| Non-preferred (includes some generics) | 40% (minimum of $120 and no maximum) |
| Non-formulary generic/brand | Not covered |
| Category | You'll pay |
|---|---|
| Generic | 20% (no minimum to maximum of $150)) |
| Preferred brand | 40% (minimum of $60 to maximum of $180) |
| Non-preferred (includes some generics) | 50% (minimum of $120 and no maximum) |
| Non-formulary generic/brand | Not covered |
