University of California Human Resources and Benefits

Home < Human Resources and Benefits Briefing < July 2005 What is the UC Medical Center Pharmacy Maintenance Prescription Drug Benefit?

UC Med Center Pharmacies will be able to dispense approved maintenance¹ medications

In mail order quantities (usually up to a 90-day supply)
At the mail order copays $20/Level I Drugs (primarily generic) listed in the Health Net Recommended Drug List; $40/Level II Drugs (primarily brand) listed in the Health Net Recommended Drug List; $70/Level III Drugs (Drugs not listed in the Health Net Recommended Drug List).

¹Maintenance Drugs are Prescription Drugs taken continuously to manage chronic or long-term conditions where Members respond positively to drug treatment, and dosage adjustments are either no longer required or are made infrequently.

Who is eligible to use this benefit?

UC Employees and Retirees and their eligible dependents (family members) enrolled in the Health Net HMO, and Health Net Seniority Plus Medical Plans.

These Medical Plans have a Retail and Mail Order Pharmacy Benefit with a copayment.

Which UC Med Center Pharmacies are participating?

There are a total of 12 pharmacies at the following Medical Centers - UCSD, UCLA, UCI and UCD.
There is NO Med Center Pharmacy at UCSF
A list of participating pharmacies will be posted on the HR/Benefits website, “At Your Service”.

How will employees and retirees be notified about this new benefit?

There will be an announcement in the July 2005 issues of Briefing and New Dimensions.

What are my options for getting maintenance prescriptions at the mail-order price?

Option 1 – Health Net’s Prescription by Mail Drug Program through Express Scripts

The employee/retiree mails a prescription or the physician faxes a prescription to Express Scripts.

Express Scripts retains the prescription and the employee/retiree will get their initial prescription and all refills for this prescription from Express Scripts.

The medication is delivered to the individual’s home address by U.S. Postal Service/UPS, etc.

Option 2 – Participating UC Med Center Pharmacies

The employee/retiree obtains a new prescription from their Physician and brings it to the participating UC Med Center Pharmacy.
The UC Med Center Pharmacy retains the prescription and the employee/retiree will get refills for this prescription from this pharmacy.
The prescriptions will be picked up at the UC Med Center Pharmacy. This is a “walk-in” service which is not structured for individual mail-out or delivery.

What if an employee/retiree has an open refill at Express Scripts and wants to get a refill at a UC Med Center Pharmacy?

If the employee/retiree wants to get refills at a UC Pharmacy for a prescription that was originally filled at Express Scripts, they must get a new prescription from their provider and bring it to the UC Med Center Pharmacy. The UC Pharmacies will not be able to get the prescription transferred from Express Scripts.

Can an employee/retiree have prescriptions filled at both Express Scripts and a UC Med Center Pharmacy?

Express Scripts and UC Med Center Pharmacies are stand-alone options operating independently.
- Members can have different prescriptions filled at Express Scripts or a UC Med Center Pharmacy. You will not be able to get the same medication from both pharmacies at the same time.
- A member can get one medication from a UC Med Center Pharmacy and a different medication from Express Scripts.
- However, a member cannot have a prescription on file at a UC Pharmacy and have Express Scripts mail them the medication, and they cannot have a prescription on file at Express Scripts and pick up the medication at a UC Med Center Pharmacy.
When will the UC Med Center Pharmacies start filling the prescriptions?
All UC Med Pharmacies will begin filling Health Net and Health Net Seniority Plus Maintenance Prescription Drugs on July 1, 2005.