PostDocs: Prescription Drug Benefits

Prescription Coverage with the PPO Plan

When you enroll in the GW Postdoc PPO medical plan option, you are automatically enrolled in the prescription drug coverage below through OptumRx. You have access to prescription medications through both retail pharmacies and a mail-order program. Under the prescription plan, generic, brand formulary and brand non-formulary drugs will be paid by fixed copay each time you fill a prescription.

Real World Tips:

• Any time you receive a prescription, ask your doctor if a generic option of the drug is available, and whether it’s right for your condition. Doing so can save you hundreds of dollars.
• If you have a condition that requires ongoing prescription medication, you will pay the lowest total copay possible by requesting that your doctor provide a prescription for a 90-day supply of your medication.
• There are no limits to the number of 30-day fills for maintenance prescriptions at an in-network retail pharmacy. There are no penalties for continuing to fill your maintenance medication every 30 days rather than moving to a 90 day fill.

A drug formulary is a list of medications published by UnitedHealthcare and can be found on myuhc.com or gwu.gpa.services.

Medications on the list fall into one of the following three categories:

1. Tier 1: Lowest cost, most commonly generic drugs, but can include some brand-name medications. A generic medication is an FDA-approved drug, composed of virtually the same chemical formula as a brand-name drug.
2. Tier 2: If a generic medication is not available for your condition, your doctor may prescribe a brandname medication. Brand, Formulary Drugs have been evaluated by physicians and pharmacists through the OptumRx network and are deemed to be the most cost-effective means of treating a specific condition. Tier 2 medications will be more expensive, but will help reduce your out-of-pockets if used in lieu of Tier 3 medications.
3. Tier 3: In the event that you require a prescription medication that is neither Generic nor on the Brand, Formulary Drug list, you will pay the highest out-of-pocket cost for a Brand, Non-Formulary Drug.

Note: You will receive one card for both your medical and pharmacy benefits.