Wondering whether an existing or new prescription is covered under your insurance plan? Good news! Your carrier has online tools for coverage, pricing, pharmacy search, etc. See below for the relevant links.
Find detailed information on prescription coverage in the plan details PDF for each plan. Use Aetna's Find a Medication tool to find a specific drug and its price under your plan found on both Aetna's website and the Aetna Mobile app!
On Aetna's website, when prompted to choose your Plan Year and Plan Type, you may use the following:
- Under "Choose Your Plan," select the year the plan starts (2019-2020 is the current plan year).
- For "Choose A Plan," select "Value Plans." This is the Plan stated in the pharmacy section of our 8-page.
OptumRx is the pharmacy care services manager for the plans. You can search for pharmacies using this link.
UnitedHealthcare also provides a Prescription Drug List, which is a list of commonly prescribed medications covered by the plan. Medications are put into tiers that determine their cost.
Once you've registered for a myuhc.com account, navigate to "Pharmacies & Prescriptions" where you'll be able to manage any existing prescriptions, order refills, get drug cost estimates, and find ways to save on your medications.
Use the Health4Me app to enroll for home delivery, find pharmacies, refill prescriptions/set reminders, estimate and compare medication costs, and/or search the plan's PDL!
Kaiser Permanente uses what is called a formulary to list the medications covered by their plans. Kaiser Permanente's formulary can be found on their website under "Health & Wellness" or by clicking here.
What is a formulary? The formulary is a list of drugs that have been approved for members by Kaiser Permanente's Pharmacy and Therapeutics Committee. Doctors and other clinicians use the formulary to help determine the safest, most effective drugs to prescribe for members.
Note: Members should ensure they're selecting their region prior to searching a drug in the Lexicomp tool.
This material has been prepared for informational purposes only, and is not intended to provide, and should not be relied on for, legal or tax advice. If you have any legal or tax questions regarding this content or related issues, then you should consult with your professional legal or tax advisor.