Prescription drugs

Medicine goes down a lot easier when it doesn’t cost you an arm and a leg. How much you’ll pay for a prescription depends on the type of medication and where you go to fill it. All plans offer convenient home delivery for certain medications—one less thing you need to think about.

Ways to save

You have options when it comes to filling prescription drugs, and the choices you make can help you save money. Here are some cost-saving tips to keep in mind:

  • Choose lower-cost generic medications over brand-name drugs and use the drug-costing tools on your insurance carrier’s website.
  • Use pharmacies in your plan network.
  • Take advantage of the mail-order service for maintenance medications.

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What you pay: UHC

The amounts shown below reflect the use of in-network pharmacies. You’ll pay more if you use a non-network pharmacy.

UHC Choice Plus High Deductible

You pay 20% after the deductible for all in-network prescriptions (retail or mail order).

UHC Choice Plus (PPO) / UHC Choice (EPO)

You pay 10%, up to the maximum listed below for all in-network prescriptions.

 Retail
(Up to 31-Day Supply)
Retail
(Up to 90-Day Supply)
Mail Order 
(Up to 90-Day Supply)*
Tier 1$20$60$40
Tier 2$50$150$100
Tier 3$80$240$160
Specialty*N/AN/A$100

*Specialty drugs are available through mail order only and limited to a 31-day supply.

Check your prescriptions

UHC’s drug look-up tool shows coverage, exclusions, authorization requirements, and more. You'll see a coverage tier for each drug, but here’s what you need to know, no matter the drug tier: You’ll pay 20% after your deductible under the UHC Choice Plus High Deductible plan and 10% coinsurance under the UHC Choice Plus and UHC Choice plans (minimums and maximums apply, refer to the chart above).

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What you pay: Kaiser

You can get a 30-day supply of medication from Kaiser pharmacies. If you're on a maintenance medication, such as high blood pressure medication, consider the mail-order option, which provides a larger quantity for just 2 times the retail copay amount. Out-of-network prescriptions are only covered in case of an emergency.

Kaiser California

 Kaiser Pharmacy
(Up to 30-Day Supply)
Kaiser Mail-Order Service
(Up to 100-Day Supply)
Generic$10 copay$20 copay
Brand$20 copay$40 copay
SpecialtyVaries by drugVaries by drug

Kaiser Oregon

 Kaiser Pharmacy
(Up to 30-Day Supply)
Kaiser Mail-Order Service
(Up to 90-Day Supply)
Generic$10 copay$20 copay
Brand Formulary$20 copay$40 copay
Brand Nonformulary$40 copay$80 copay
Specialty$150 copayNot available

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