Please view the prescription drug co-payment information and coverage schedule for your drug plan. You can confirm your drug plan type by referring to your member ID card, asking your Plan Administrator, or contacting HMAA.
If there is a generic equivalent available and a brand name (preferred or non-preferred) drug is dispensed, you may be responsible for the respective brand co-payment plus the cost difference between the generic and brand name drug.
The amount you pay for a covered drug will depend on your coverage tier. Each covered drug is in one of several tiers. Each drug’s tier amount may be different. Each drug tier may have a different copayment or coinsurance amount. Please refer to your Drug Certificate (“DRC”) for additional information. To find out the cost of your drugs, you may contact OptumRx toll-free at 1-800-880-1188.
In your prescription plan, the formulary drug list is used as a guide for determining your co-payment for each prescription, with drugs listed on the formulary typically available at a lower co-payment. However, only you and your doctor can decide which medications are right for you. You may also view the preventive care medications.
HMAA’s drug formulary is developed by our pharmacy benefit manager, OptumRx. Our formulary is updated on January 1 and July 1. By making updates twice a year, we are able to keep pace with current market trends, price changes, and new clinical information. Review the list carefully, and note it is not all-inclusive and is subject to change.
- Effective July 1, 2024 through December 31, 2024:
- Effective January 1, 2025 through June 30, 2025:
- HMAA requires precertification (also known as Prior Authorization, or PA) of certain prescription drugs. Your prescribing physician will handle PAs directly with our medication reviewer, RxBenefits.
You can request convenient, cost-effective delivery of prescription drugs right to your door through OptumRx home delivery service. You may register online and submit orders 24 hours a day, 7 days a week through the OptumRx member portal or via their mobile app, or print and complete the Mail Order Prescription Form.
With our Step Therapy Program, you can receive the most cost-effective covered medications for various drug categories as early as possible in your treatment plan.
Our Opioid Risk Management Program aims to minimize your exposure to risks associated with misuse, abuse, and addiction to opioids.
Our Member Advocates will assist you with identifying and enrolling in Copay Assistance Programs funded and supported by drug manufacturers. If eligible, HMAA will work with you to maximize utilization of these programs to lower the cost of your covered medications, which is ultimately shared by you and HMAA, without compromising the treatment you need.
Our pharmacy benefit manager, OptumRx, provides free online access to help manage your prescriptions. Once you are registered, you can learn more about your prescription benefits and obtain maintenance medications through home delivery. Register or Sign In.
