Prescription Benefits
As announced, for 2021, you’ll have a choice of three consumer-driven health plans (CDHPs). Whether or not CDHPs are new to you, open enrollment is a good time to review how prescriptions are covered within CDHPs. How Prescriptions Work with CDHPs You pay prescription costs in full until you meet your deductible. With CDHPs, you pay the cost of your prescription medications in full based on contracted (or discounted) rates until you meet your deductible. There is one exception to this: generic medications are always covered at 100 percent. Remember: You have one deductible for both medical services and prescriptions. After you meet your deductible, you share the costs with Purdue. Once you meet the deductible, Purdue helps you with the cost of prescriptions. Generic preventive medications continue to be covered at 100 percent, and generic non-preventive medications will never cost you more than $10. Important tip: You can save with mail order. If you are on a maintenance medication (a prescription you take monthly) and have it fulfilled via mail order, you can save on a 90-day supply — basically getting one month free. You pay your share of prescription costs until you reach your out-of-pocket maximum. At that point, Purdue will cover any remaining prescription needs for the remainder of the year. Once you have paid your share of medical and prescription costs to meet your out-of-pocket maximum for the year, then your prescription (and eligible medical) expenses will be covered in full by Purdue.
How to Be a Smart Rx User We understand that if you’re not used to paying prescription costs in full, this may be a difficult transition. Here are four things that may help: Purdue is depositing the annual HSA contribution ($325 individual / $650 family) in full in January, giving you access to funds at the start of the year. You can use HSA, HRA or your healthcare FSA dollars to pay for prescriptions. (Note: If you are not eligible for an HSA, you can receive the funds in a HRA.) You can participate in the Healthy Boiler Wellness Program and earn additional funds in your HSA or HRA to help pay for your qualified expenses, like your prescriptions. Consider taking what you’ll save on premiums (CDHPs have lower premiums) and putting that extra money in your HSA via payroll deduction to build up your account. Set up a FREE account with Rx Savings Solutions. This confidential program works in conjunction with Purdue’s prescription coverage to provide personalized prescription guidance. With Rx Savings Solutions, you’ll be able to:
Speciality Medications Like other prescriptions, you’ll pay the full cost of specialty medications until you meet the deductible. After that, you’ll be responsible for 55% of the cost, up to a maximum of $250 per prescription. We understand that specialty medications can be expensive. Drug manufacturers often offer a copay assistance program. If you take advantage of a copay assistance program, keep in mind that only the amount you pay applies to the deductible and out-of-pocket maximum. Example: Humira
Most copay assistance programs have a limit, typically only covering a certain amount of doses. Once the copay assistance amount is exhausted, you will pay the full amount of the drug until your deductible is met. Then, once your out-of-pocket maximum for the year is met, prescription and eligible medical expenses will be covered in full by Purdue.
Need More Help? For more information on how Purdue’s CDHPs work with prescription coverage, download our plan-by-plan comparison. Watch for more emails from benefits in the coming weeks. We’ll provide information on a regular basis to help you prepare for the 2021 benefits enrollment period.
hr@purdue.edu |