Prescription Drug
Prescription drugs are an important part of your health plan coverage. HMSA provides
comprehensive medication coverage and convenient, affordable ways for you to purchase
prescription drugs.
HMSA’s prescription drug coverage is designed to offer you a broad range of
medication choices while you share in the cost through copayments. You can get your
prescriptions filled at your local pharmacy or through the convenience of
HMSA’s Mail Order Prescription Drug Program.
Whatever method you choose, your HMSA drug plan benefits will have you covered.
Pharmacy Network
HMSA prescription drug plans feature access to over 99 percent of participating
pharmacies in Hawaii and a nationwide network
of more than 67,000 pharmacies.
HMSA’s Mail Order Prescription Drug Program
Receive the convenience of having your maintenance medications delivered directly
to your home safely and efficiently.
HMSA’s Mail Order Prescription Drug Program is for members who take
maintenance medications – prescription drugs taken on a regular basis for
conditions such as high cholesterol, high blood pressure, diabetes, or arthritis.
It’s a convenient and affordable way to obtain up to a 90-day supply of your
medications.
Note: HMSA’s Mail-Order Prescription Drug Program does not apply to all HMSA
drug plans. Check with your employer or call HMSA if you have questions.
Most HMSA members have a drug benefit that includes three copayment levels or tiers:
- Tier 1: Generic – You pay the lowest copayment. Generic drugs have the same active
ingredients, strength, and dosage as brand-name drugs, but cost less. Using generic
drugs is a convenient way to save money on your medications.
- Tier 2: Preferred Brand – You pay a higher, fixed copayment than generic drugs.
Many brand-name drugs are designated as Preferred Brand when generic alternatives
are not available.
- Tier 3: Other Brand – You pay the highest copayment. Drugs in this tier often have
generic or preferred brand alternatives that are considered just as effective. The
out-of-pocket cost for Other Brand drugs is the Tier 2 copayment plus an additional
cost share.
Note: The three-tier formulary does not apply to all HMSA drug plans. Check with
your employer or call HMSA if you have questions.
Lifestyle Changes
There may be lifestyle changes you can make to reduce or eliminate your need for
prescription medication for some medical conditions. Ask your doctor if changing
your diet or starting an exercise program can help reduce your use of medications.
Manage Your Medications
The high cost of prescription drugs contributes to rising health care costs. HMSA
encourages you to use generic drugs when appropriate to help manage your prescription
drug costs. To learn more about generic drugs and how to make the most of your prescription
drug benefits, visit generic drugs in the Community Awareness section.
Eligibility: HMSA’s prescription drug benefits are available for Preferred
Provider, CompMED and HMO plans through an employer group health plan. Check with
your employer regarding your health plan benefits.
