Prescription Drugs

Just like your medical plan covers visits to your doctor, your prescription plan covers the medicine your doctor prescribes. Whether you pick up your prescription at your neighborhood pharmacy or have it delivered directly to your home or office, we’ll make sure you and your family get affordable medicine, quickly and conveniently. Express Scripts’ dedicated team of pharmacists, nurses, and patient care advocates deliver personalized care for everyone covered by your plan. Learn how to get the most from these benefits below.

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Prescription Drugs

Best Practices for Prescription Benefits

The cost of prescription drugs is rising faster than any other category of medical expense. Using your drug benefit wisely can save you money. The following tips can help to reduce your out-of-pocket expenses for prescription drugs:

  1. Ask for generic drugs.
    Generic drugs save you money because they are typically a quarter of the cost of brand name drugs, and are just as safe and equally effective1. Always ask your physician if a generic drug is available for you, and to note that the generic form is acceptable on your prescription.

  2. Take advantage of Express Scripts benefits.
    Express Scripts is the largest independent manager of pharmacy benefits in the United States and one of the country’s largest pharmacies, serving more than 85 million people. We all know healthcare is complicated – that’s why they’re available 24/7 to give you the information and support you need to take control of your health. Whether you want to find the best prices, manage medicine for your household, or talk to their specialist pharmacists to help you understand your therapy, they’re there to help.

  3. When a generic drug is not available, ask for a “preferred brand.”
    When a new drug is developed, the law prohibits the making of its generic equivalent for seven years. This is why not all brand name drugs have a generic counterpart. If you are on a drug that does not have a generic equivalent:

    • Ask your doctor if there is another drug for your condition that has a generic equivalent.

    • If not, ask your physician to prescribe a brand name drug that is on our Preferred Drug List2 .

  4. Accept medication samples with a generic equivalent, or one that is on the UHA Preferred Drug List2.
    If your doctor starts you out on a sample brand name medication that works, you are likely to be given a prescription for that brand, which may be subject to a higher co-payment. When it comes to chronic problems such as high blood pressure, diabetes, or high cholesterol, you will more than likely be on such medication for a long period of time. As a result, your higher co-payments will quickly add up. Always ask your doctor about generic equivalents when starting on a new medication.

  5. Switch all regularly taken medications to be refilled by mail order2.
    You can purchase maintenance medications through UHA’s mail order services with Express Scripts. It’s quick and convenient, and saves you money by allowing the purchase of a 60-day supply for most brand drugs or a 90-day supply for generic drugs. Medications can be sent to your home or office with free shipping.

      Home Delivery

      You can purchase maintenance medications through UHA’s mail order services with Express Scripts. It’s quick and convenient, and may save you money by allowing the purchase of a 60-day supply for most brand drugs or a 90-day supply for generic drugs. Most medications can be sent to your home or office with free shipping.

      Enroll in Express Scripts Home Delivery

      Manage your prescription orders via a single login using your UHA Member Portal account. Call 800.282.2881 to contact Express Scripts’ Patient Customer Service if you need help enrolling.

      • 24/7 access to a pharmacist in the privacy of your own home
      • Save up to 25% less than retail pharmacies
      • Free standard shipping*

      Don’t have a UHA Member Portal account? Register for a new account to view your specific UHA plan benefits and manage your prescriptions filled by Express Scripts.

      *Medications containing certain controlled substances are shipped United Parcel Service (UPS). If necessary, you can request express shipping, which is available for an additional fee.

      Extended Fill

      Members may obtain an extended supply of their maintenance medications at most UHA-participating retail pharmacies within the Express Scripts network. Find a participating pharmacy using our “Find a Provider” tool:

      Find a Provider

      This walk-in service allows members to purchase a 60-day supply (for most brand name drugs) or a 90-day supply (for generic drugs) for their prescription maintenance medication. To start the service, show your Member ID Card when picking up your prescription from the pharmacy, and ask if you are eligible for an extended fill.

      Not sure if your prescription is on the preferred drug list?

      Take the Next Step:

      Learn more about your benefits.

      1 A preferred drug list helps keep healthcare costs down for everyone. It is a list of drugs that have been reviewed and approved for safety by doctors and pharmacists. This list is updated as new drugs become available.
      2 Controlled substances are available via mail order within Hawaii (30 day supply). For availability to other states, call Express Scripts at 855-891-7978 (Toll Free).
      3 Note that certain drugs are excluded from your formulary and therefore not covered due to equally effective and safe alternatives being available.
      4 UHA’s drug plans cover most categories of prescription medications. However, some categories of drugs are not covered. These include (effective January 1, 2019):

      • Injectable drugs except Lovenox, Glucagon, Imitrex, Depo Provera, Insulin and anaphylaxis (Epinephrine) kits
      • Fertility agents
      • Drugs used for cosmetic purposes
      • Supplies, appliances and other non-drug items, except Diabetic Supplies
      • Drugs furnished to hospital or skilled nursing facility inpatients
      • Drugs prescribed for treatment plans that are not Medically Necessary
      • Anti-obesity drugs
      • Sexual function drugs
      • Any drug that may be purchased without a prescription over-the-counter (OTC), except as specified below
      • OxyContin (or its generic equivalents) and all other extended-release and long-acting narcotics, unless prescribed in compliance with UHA’s Prior Authorization conditions and payment policies
      • Drugs for which Prior Authorization is required but has not been obtained
      • For drugs in a therapeutic class in which a former prescription drug in that class converts to an OTC drug, UHA reserves the right to
      • provide coverage only for the former prescription drug that has converted to an OTC drug and to exclude from coverage all other drugs in that class
      • Drugs and/or Diabetic Supplies obtained by mail order or extended fill from a Non-Participating Pharmacy
      • Non-essential, low value and no value drugs; some of which are non-FDA approved, some are approved but hold no identifiable advantage over other more well-tested agents and some are considered to be of lower value by pharmacologists, professional organizations, other authorities, or all three. This list is to be updated annually
      • Products that are chemically-similar drugs and share the same mechanism of action to an existing, approved chemical entity and offer no significant clinical benefit
      • Drugs that are determined by the Pharmacy Benefits Manager due to availability of equally effective and safe alternatives