Results for Prescription Drugs

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Prescription Drugs with the HRA Option

With prescription drug coverage in the HRA option, you don’t have to meet your medical deductible before you start enjoying prescription drug benefits. This prescription drug coverage also has an out-of-pocket maximum, which limits how much you have to pay for prescription drugs during the year.

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Use your prescription drug coverage through CVS/caremark to get your flu shot for free at an in-network pharmacy of your choice. Find a list of qualifying pharmacies at caremark.com.

 HRA Retail (up to 30-day supply)HRA Mail Order (up to 90-day supply)
Deductible

None

None

What The Plan Pays: Value-Based Generic Copay

100% after $5 copay
Includes medication for high blood pressure, high cholesterol and diabetes

100% after $10 copay
Includes medication for high blood pressure, high cholesterol and diabetes

What The Plan Pays: Generic Copay

100% after $10 copay

100% after $20 copay

What The Plan Pays: Value-Based Preferred Brand Name Coinsurance

90% ($50 max/Rx)
Includes medication for high blood pressure, high cholesterol and diabetes

90% ($100 max/Rx)
Includes medication for high blood pressure, high cholesterol and diabetes

What The Plan Pays: Preferred Brand Name Coinsurance

80% ($100 max/Rx)

80% ($200 max/Rx)

What The Plan Pays: Value-Based Non-Preferred Brand Name Coinsurance

80% ($60 max/Rx)
Includes medication for high blood pressure, high cholesterol and diabetes

80% ($120 max/Rx)
Includes medication for high blood pressure, high cholesterol and diabetes

What The Plan Pays: Non-Preferred Brand Name Coinsurance

60% ($120 max/Rx)

60% ($240 max/Rx)

HRA Rx Out-of-Pocket Maximum

You
$1,000

You + one
$1,500

You + family
$2,000

You
$1,000

You + one
$1,500

You + family
$2,000

Reasonable and Customary Charges: A charge is considered “reasonable and customary” (R&C) if it matches the general cost of that service within your geographic area. If your health care provider charges above the reasonable and customary charge, you may have to pay the difference between the R&C charge and how much your provider charges.

Value-Based Prescription Discount

If you are enrolled in the HRA option and take medication for high blood pressure, high cholesterol or diabetes (medications only), you will pay 50% less for your value-based prescriptions. These conditions were selected for special value-based pricing because improving them will have the largest impact on the overall health of Rockwell Automation employees.

Preferred vs. Non-Preferred Brand Name Drugs

Preferred brand name (or formulary) drugs have been determined to provide effective treatment when used as intended and typically cost less then non-preferred brand name drugs. Non-preferred brand name (or non-formulary) drugs tend to be expensive and often have a less expensive generic or preferred brand name alternative available.

Brand Penalty

A brand penalty is what you pay if you choose to fill your prescription with the brand name drug instead of the available direct generic version. The penalty amount is the difference between what the brand name drug costs and what the generic drug costs.

If you are prescribed a drug that does not have a generic version and is not on the indirect generic list, you will not be charged the brand penalty for filling that brand name drug.

Brand Penalty Does Not Count Toward Out-of-Pocket Maximum

The brand penalty, or cost you pay for filling the brand name drug versus the generic drug, does not count toward your out-of-pocket maximum.

Using the Money in Your HRA

You can use the money in your Health Reimbursement Account (HRA) to pay for eligible medical expenses for you and your dependents covered by the plan. Eligible expenses include prescription drugs, office visits and hospital expenses. If you do not use all the money in your HRA during the year, the funds roll over to the next plan year if you stay in the HRA option.

Save Money with Generics

Generic drugs may look a little different than the brand name prescriptions, but they are just as effective, and they consist of identical ingredients in the same formulation. Plus, every ingredient that goes into a generic drug must be approved by the FDA.

If your pharmacy fills a brand name medication for any reason and a generic is available, you will pay the difference between the brand name and the generic, plus the brand coinsurance.

Save money and go generic the next time you’re at the pharmacy.

Compound Drugs

Compound drug prescriptions that cost more than $300 require prior authorization.