Maximize Your Prescription Drug Benefits

Benefit Tips

The cost of prescription drugs is rising faster than any other category of medical expense. Using your drug benefit wisely can save you money. The following tips can help to reduce your out-of-pocket expenses for prescription drugs:

1. Ask for generic drugs.
   Generic drugs save you money because they are typically a quarter of the cost of brand name drugs, and are just as safe and equally effective¹. Always ask your physician if a generic drug is available for you, and to note that the generic form is acceptable on your prescription.
2. When a generic drug is not available, ask for a “preferred brand.”
   When a new drug is developed, the law prohibits the making of its generic equivalent for seven years. This is why not all brand name drugs have a generic counterpart. If you are on a drug that does not have a generic equivalent:
   • Ask your doctor if there is another drug for your condition that has a generic equivalent.
   • If not, ask your physician to prescribe a brand name drug that is on our Preferred Drug Listing².
3. Accept medication samples with a generic equivalent, or one that is on the UHA Preferred Drug Listing².
   If your doctor starts you out on a sample brand name medication that works, you are likely to be given a prescription for that brand, which may be subject to a higher co-payment. When it comes to chronic problems such as high blood pressure, diabetes, or high cholesterol, you will more than likely be on such medication for a long period of time. As a result, your higher co-payments will quickly add up. Always ask your doctor about generic equivalents when starting on a new medication.
4. Switch all regularly taken medications to be refilled by mail order².
   Medications dispensed at the pharmacy are limited to a 30-day supply. However, you can purchase maintenance medications through UHA’s mail order service at Longs Drugs/CVS. It’s quick and convenient, and saves you money by allowing the purchase of a 60-day supply for most brand drugs or a 90-day supply for generic drugs under a single co-payment, and medications can be sent to your home or office.

1. The Preferred Drug list has both generic and preferred brand alternatives for every category of drugs. This list has been developed by physicians and pharmacists to include drugs that are known to be cost-effective.
2. Controlled substances are available via mail order within Hawaii (30 day supply). For availability to other states, call Longs Drugs Mail Order at 1-800-547-7943.

UHA’s drug plans cover most categories of prescription medications. However, some categories of drugs are not covered. These include:

• Drugs that are not approved by the FDA (Food & Drug Administration)
• Drugs available without a prescription (“over the counter”)
• Drugs for treating hair loss, sexual dysfunction, wrinkles, or weight loss
• New Drugs – All drugs newly-approved by the FDA have a four month waiting period before coverage begins. This four-month period allows UHA time to investigate the new drug for safety and efficacy.
• Injectable drugs except Insulin and anaphylaxis (Epinephrine) kits
• Immunization agents
• Fertility agents
• Drugs used for cosmetic purposes
• Supplies, appliances and other non-drug items, except Diabetic Supplies
• Drugs furnished to Hospital or Skilled Nursing Facility inpatients
• Drugs for which Prior Authorization is required but has not been obtained
• Drugs and/or Diabetic Supplies obtained by mail order from a Non-Participating Pharmacy