Benefit Connections    FAQ
About the Prescription Drug Program

  Who should I call if I have questions about prescription drugs for 2019?

You should contact Optum Rx at 1-866-317-6359 with questions regarding prescription drugs.

  How do I find a participating network retail pharmacy?

You can locate a network retail pharmacy by visiting www.myuhc.com and accessing the pharmacy link or by calling Optum Rx at 1-866-317-6359.

  What if the cost of the generic or brand-name drug is less than my copay?

If the cost of the prescription is less than your copay, you would pay the cost of the prescription.

  How can I find out if my medications are on the Prescription Drug List?

You may access a copy of the prescription drug list on Benefit Connections under the Annual Election Resources tab or www.myuhc.com. You may also contact OptumRx at 1-866-317-6359.

  Are low cost drugs the only ones on the Prescription Drug List?

The prescription drug list is a comprehensive list of therapeutic medications. There are three tiers of prescription drugs with varying drug costs that are set by the pharmaceutical manufacturers. The amount of your out of pocket cost will be based on the drug tier and what the plan covers for a particular drug.

  Do doctors know which drugs are on the Prescription Drug List?

Your physician has a general idea of what most plans should cover, but will not know the provisions of your CITGO coverage. It is important that you talk to your doctor about the medications on the Prescription Drug List when he or she is prescribing your medication. You can access the Prescription Drug List on Benefit Connections or www.myuhc.com.

  What is the mandatory generic drug provision?

The mandatory generic drug provision applies for CITGO’s prescription drug program. Under this provision, you do not have to use generic drugs, but you will have to pay more for a brand name drug if:

  • Your physician writes a prescription that does not include “dispense as written"
  • When generic is available and you request the name brand.
  • Your cost will be the coinsurance percentage of the applicable drug tier plus the difference between the cost of the brand name drug and the cost of the generic drug.

  What’s the difference between a generic and brand name drug?

Essentially a generic is the same as a brand-name medication. A generic is a therapeutically equivalent medication that can be produced once the patent or registered trademark has expired on its brand-name counterpart. It has been fully tested and approved by the Food and Drug Administration and is usually identified by its chemical name. The Food and Drug Administration has mandated that generic medications meet the same standards as their brand-name counter-parts in strength, safety purity, performance, and that they be manufactured according to federal standards. The colors or shapes of the generic medication will differ from their brand-name counterparts, but this does not affect their standard of quality.

  Are generic drugs safe?

Yes. The Food and Drug Administration requires that all medications be safe and effective. Because generics use the same active ingredients as brand-name medications, they have the same benefits and risks as their brand-name counterparts.

  How much can I save by using generic drugs?

Your individual savings will depend on your specific prescription drug needs. Under the CITGO prescription drug program, using generic drugs instead of a preferred brand or non-preferred brand drug could reduce your out-of-pocket expenses.

  Do all drugs have generic equivalents?

No. Some drugs are protected by patents and are supplied by only one company. However, when the patent expires, other manufacturers can produce its generic version. Currently, about half the drugs on the market are available in generic form.

  Will my doctor automatically prescribe generic drugs?

It depends on the physician. You can ask your doctor to write a prescription permitting generic substitution if it is right for your treatment plan. The lowest cost option will usually be the generic version of a medicine; however, your doctor may want you to take a brand drug for specific reasons related to your health care.

  How can I get generic drugs?

Talk with your doctor or pharmacist. Explain that you want the most effective drug at the best price, and ask your doctor to write prescriptions for generic drugs when possible.

  What should I think about when reviewing the Prescription Drug Program?

As you are considering your options, you may think about the following:

  • Consider Generic Drugs - Generic drugs have the same medical effect as brand-name drugs, but usually cost less. Ask your doctor about generics.
  • Check out the Mail Order program to see if your cost will be more affordable if you purchase a 90 day supply of any maintenance medications you may be taking.
  • Compare Different Drugs - There is evidence-based research (EBR) that helps you compare drugs developed to treat a particular condition; this research also explains what the drugs do and how much they cost. Locate a consumer guide that summarizes and compares evidence about some drugs for many common conditions.
  • Find Discounts - Just like shopping for clothes or food, you can research and shop for medication discounts.