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All Princeton medical affairs accommodate decree advantage through OptumRx. Advantage varies depending on your medical plan election.  

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If You Choose:

Then:

Consumer Directed Health Plan (CDHP)

Coverage is provided afterwards the medical plan’s anniversary deductible(s) are met. Exceptions for actual advantage are antitoxin drugs and IRS appointed drugs for abiding conditions.   

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All added Princeton Medical Plans

Coverage begins anon behindhand of affair your medical plan’s deductible.

You pay for your prescriptions with a copayment that is bent by the blueprint and whether you use a retail pharmacy or the lower amount mail adjustment program. A blueprint is a account of assigned medications that accept accurate to be both clinically and amount effective. Prescriptions on the blueprint are categorized into three tiers and those tiers actuate your amount for a medication. Some prescriptions may be afar from the formulary. There are adopted articles in every ameliorative chic in the formulary.  

There is a above-mentioned allotment action for analytic exceptions through OptumRx. As an example, if you are demography a non-preferred or afar medication due to an allergic acknowledgment to the adopted cast equivalent, your provider will charge to book a above-mentioned allotment with OptumRx. If the above-mentioned allotment is approved, you will alone be amenable to pay the adopted cast copay.

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For advice about your decree allowances appointment the OptumRx website or alarm OptumRx affiliate casework at (877) 629-3117.

Retail Pharmacy (30-Day Supply)

Mail Adjustment (90-Day Supply)

Generic

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$5 copayment

$10 copayment

Preferred Brand

$25 copayment

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$50 copayment

Non-Preferred Brand

$40 or affiliate pays the difference

$80 or affiliate pays the difference

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Infertility Advantage (oral and injectable medication): Same as aloft up to a $20,000 lifetime maximum.

You will accept a abstracted ID agenda for the decree biologic affairs administered through OptumRx.

Princeton University participates in Above-mentioned Authorization, Step Therapy, and Abundance Duration Programs for assertive assigned medications. An OptumRx pharmacist may charge to allege with the prescribing physician to ensure that the accommodating meets the belief for the decree prescribed.  In addition, the abundance of some decree medications may be bound based on FDA regulations ensuring accommodating safety.  If your physician deems it all-important for your affliction and treatment, he or she may address OptumRx’s decision.

Through OptumRx by Mail, prescriptions are delivered to your home, and you can get a 90-day accumulation of aliment medications for the amount of a 60-day accumulation purchased at a retail pharmacy.

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There is a Home Delivery Incentive Affairs through OptumRx by Mail for participants who are on aliment medication.  If you ample your aliment prescriptions through Optum Rx Home Delivery Service (mail order), you will accept a three-month (90-day) accumulation for the amount of a two-month (60-day) supply.  However, if you renew your decree for aliment medication through a retail pharmacy for added than three months, consecutive refills will amount twice the retail pharmacy copayment rate. 

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