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.
Generic prescription drugs are usually your best value. They contain the same active ingredients as brand-name equivalent drugs at a lower cost. UK is a founding member of the Know Your Rx Coalition (KYRx), which has pharmacists on staff to help you find money-saving alternatives to your current medications and answer any prescription-related questions.
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. Retirees enrolled in Medicare are not eligible for this discount.
Express Scripts is our benefit manager for prescription coverage
Or call Express Scripts at (877) 242-1864 Monday through Friday, 7:30 a.m. to 5:30 p.m. Central Time.
UK Pharmacists can be reached at (859) 218-5979.
Co-insurance and copays per prescription
Health plan members
30-day prescriptions 30-day supply or less
HMO, PPO, RHP, EPO, Indemnity
| 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 |
UK Saver
| Category | After deductible, you'll pay |
|---|---|
| Generic | 20% |
| Formulary brand | 40% |
| Non-formulary brand | 50% |
| Speciality generic | 20% |
| Speciality brand* | 50% |
Before your annual deductible is met, you'll pay 100% of the cost of your prescriptions.
90-day prescriptions 31- to 90-day supply (UK pharmacies and Express Scripts)
HMO, PPO, RHP, EPO, Indemnity
| 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) |
UK Saver
| Category | You'll pay (after deductible) |
|---|---|
| Generic | 20% |
| Formulary brand | 40% |
| Non-formulary brand | 50% |
| Speciality generic | N/A (limited to 30 days) |
| Speciality brand* | N/A (limited to 30 days) |
Before your annual deductible is met, you'll pay 100% of the cost of your prescriptions.
*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 |
|---|---|
| Most generics | 20% (no minimum to maximum of $50) |
| Preferred brand and some generics | 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
Express Scripts
| Category | You'll pay |
|---|---|
| Most generics | 10% (no minimum to maximum of $100) |
| Preferred brand and some generics | 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 |
UK pharmacies, Walgreens, select independent pharmacies
| Category | You'll pay |
|---|---|
| Most generics | 20% (no minimum to maximum of $100) |
| Preferred brand and some generics | 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
Express Scripts
| Category | You'll pay |
|---|---|
| Most generics | 10% (no minimum to maximum of $100) |
| Preferred brand and some generics | 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 |
UK pharmacies, Walgreens, select independent pharmacies
| Category | You'll pay |
|---|---|
| Most generics | 20% (no minimum to maximum of $150)) |
| Preferred brand and some generics | 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 |
What is the difference in getting a 90-day supply from Express Scripts Home Delivery and one of the UK Retail Pharmacies?
The coinsurance for 90-day prescriptions are 10% per Tier less than the 30-day supply rate when filled at either a UK Retail Pharmacy (includes Kentucky Clinic Pharmacy, Chandler Retail Pharmacy, and University Health Service Pharmacy) or at Express Scripts Home Delivery Pharmacy. Due to discount pricing at the UK Retail Pharmacies your coinsurance may be lower at one of the UK Retail Pharmacies than at Express Scripts Home Delivery.
Are there benefits for me if I get 90-day prescriptions from either UK Retail Pharmacies or Express Scripts Home Delivery?
The coinsurances for 90-day prescriptions are 10% per Tier less than the 30-day supply rate. There are minimum and maximum copays in place, so for lower cost medications there may not be a financial benefit to getting a 90-day supply. In these cases, the benefit is the convenience of having free home delivery from Express Scripts as well as having to make fewer trips to the pharmacy . For medications that reach the maximum copay there is a significant financial benefit in getting a 90-day supply.
I am using one of the discount generic programs ($4 generics) that are available at Kroger’s and Wal-Mart. Will Express Scripts or Kentucky Clinic Pharmacy match those prices?
The $4 and $10 generic programs that are available at major retailers are a great value to both the member and the plan. The UK Retail Pharmacies also offer a $4/$10 generic discount program similar to these major retailers. We strongly encourage you to continue to use these programs for any generic medications that are available through these programs. Your opportunities for savings with Express Scripts may lie primarily with brand name medications and for generic drugs not included in these discount programs.
What do I do if I need to get an antibiotic or a prescription that I need right now?
The Home Delivery option is only for maintenance medications, those that you take every day for treatment of chronic conditions such as high blood pressure and diabetes that you would want to fill in 90-day supplies. For medications to treat an acute condition such as an infection or an allergic reaction you will still fill at the local pharmacy of your choice so that you can receive immediate treatment.
Can I get some of my prescriptions at Express Scripts Home Delivery and still get some at my local pharmacy?
Certainly! You can pick and choose which, if any, medications you want to obtain from Express Scripts Home Delivery and which you want to get filled at your local pharmacy. There may be factors other than cost that may guide your decision. If you are concerned about ready access to a medication and just aren’t comfortable with getting that particular medication through Home Delivery you can still pick and choose on any basis. Again, you have full choice, in if and how you use Express Scripts Home Delivery.
Will my copays at Express Scripts Home Delivery for 90-day supplies be different than my copay for 90-day supplies at Kentucky Clinic Pharmacy?
Your copays at Kentucky Clinic Pharmacy will be the same price or less as through Express Scripts Home Delivery (mail order).
If I want to participate, how do I sign up?
If you want to enroll in the Express Scripts Home Delivery program you can call the number on the back of your Express Scripts ID card or enroll online. You may request that the Express Scripts Home Delivery program contact your physician to get 90-day prescription orders on your behalf or you can mail in Rxs to Express Scripts along with the Mail Order enrollment form. View specific instructions for the Home Delivery program on the UK Rx Forms page. The pharmacists in the HR Benefits office can assist you in getting a 90-day prescription from your doctor if you so desire.
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Benefits
All UK health insurance members are eligible for this free service.
Contact our office
Monday-Friday from 8 a.m. to 5 p.m.
(859) 257-9519
benetfits@uky.edu