AMC Value Added Extras and Pharmacy Overview
Value Added Extras! • myuhc.com – your consumer portal! • My healthcare cost estimator tool • Personal Health Record • Health Statements • Nurseline – 24/7 • Care 24 – EAP • Healthy Pregnancy Program • UnitedHealthAllies – discount program • Healthy Mind, Healthy Body Newsletter • Source4Women • Storytellers • Health4Me app for smartphones!
Being a better pharmacy consumer • Tiers • Mail Order • ½ Tab Program • Diabetic Test Strips / Glucose Meters • Consumerism - Generic Prescription Programs • Formulary Changes
Tier Designations • We are all familiar with the PDL classifications which is set up as follows: • Generic • Preferred Brand (no generic/therapeutic alternatives • Non-Preferred Brand (generic or therapeutic alternatives available) • UHC actually was the first to introduce this formulary concept back in the 1980’s • We moved to the following PDL concept: • Tier 1 • Tier 2 • Tier 3 * PDL – Prescription Drug List
Mail Order -Mail Order Applies to Maintenance Medications needed to sustain conditions on going (Diabetic Insulin, Blood Pressure, Asthma, Cholesterol, etc) -Have Provider write script for a 90-Day Supply (with 3 refills covers you for 1 year) -Fill out Mail Order Request form and include script(s) or provider can fax in via secured fax# provided by OptumRx
Voluntary Half-Tablet Program The UHPS Half Tablet is unique in several ways: -It is completely voluntary. -Members choose to participate. -It respects the physician/member relationship by requiring physician involvement in the decision. -Medications are reviewed for certain clinical criteria and must be deemed safe and appropriate for “splitting.” -Members save between $150 and $300 annually. -Members can receive a FREE tablet splitter by calling 1-877-471-1860 or go towww.halftablet.com.
Half Tab Savings Example Retail Copay Regular plan participant (30) 20 mg pills @ $3 (ingredient cost) = $90 Tier 2 copay: $35 Half-Tab participant (15) 40 mg pills @ $3 = $45 50% of Tier 2 copay: $17.50 Member saves: $17.50/month ($210/year)  Based on “flat” pricing of medication, i.e. 20 mg and 40 mg identical AWP.
Diabetic Blood Glucose Supplies (Test Strips) • All Test Strips are Brand Name products that typically have a Tier 2 or 3 copay requirement • The following Brand Name test strips have a Tier 1 ($10 retail/ $25 mail order) copay: • FreeStyle (FreeStyle, FreeStyle Flash, ) • One Touch (One Touch, One Touch Ultra, UltraSmart System) • Precision (Precision Xtra) • Contact Abbott Diabetes Care for a FREE Glucose Meter on FreeStyle and Precision test strips • Toll-free: 1-866-224-8892 Order code: UHC001 • Contact LifeScan, Inc for a FREE Glucose Meter on OneTouch test strips • Toll-free: 1-888-768-5477 Order code: 426UHC001
Additional Ways to Save Money: On-line Coupons • Know your benefit • Review your medication list • Are there lower cost alternatives? (myuhc.com, professional resources) • Is this product appropriate for home delivery/Half Tablet Program? • Talk with your doctor
Consumerism • Wal*Mart • 300+ Generics for $4 (30-day) $10 (90-day) • If your drug is on the list, you just saved $6 a month ($72 annually) at retail or $15 every 90-days ($60 annually) at mail order on each generic medication you utilize. • Kroger • 300+ Generics for $4 (30-day) $10 (90-day) • If your drug is on the list, you just saved $6 a month ($72 annually) at retail or $15 every 90-days ($60 annually) at mail order on each generic medication you utilize. • Publix • FREE Antibiotics
Be An Active Member of Your Health Care Team Physicians, physician assistants, nurses, pharmacists, andYOU make up your health care team.To minimize the risks and maximize the benefits ofmedicine use, you need to play an active role on the team…www.fda.gov/cder
Wellness Kickoff!!! • Mark your calendars for February 27, 2013 @ 11:45am! • Simply Engaged Wellness Program Lunch and Learn • Listen for opportunities to earn gift cards! • $175 for employee only and $350 for employee and spouse! • Register for the Onsite Screening – March 28th!! • Attend the screening and be registered to win one of 3, $50 gift cards!