Prescription Coverage

Prescription Coverage

Beginning January 1, 2023, prescription coverage will be administered through Highmark’s partnership with Express Scripts. Specialty medications will be administered by Accredo.

Participating employees can continue to utilize University Health Services (UHS) for their pharmacy needs or utilize an in-network pharmacy to fill their prescriptions under Express Scripts/Accredo.

Additional details regarding University Health Services Pharmacy are located through Penn State’s Office of Student Affairs.

All major chains, except Walgreens, are included in the Express Scripts pharmacy network. If your current pharmacy is participating with Express Scripts, you will simply need to present your new Highmark ID card, for your prescription to be processed correctly under your medical plan. You can verify your pharmacy by visiting the Highmark and clicking on Find A Doctor Or Pharmacy using more detailed instructions below:

Locate an in-network Pharmacy

  1. After clicking Find a Doctor or Pharmacy, click on Find A Pharmacy.
  2. Next you will need to select Locate a National Network Pharmacy.
  3. Enter Zip Code and click Search to locate an in-network pharmacy near you.

Find your prescription on the Formulary

  1. After clicking Find a Doctor or Pharmacy, click on Find a Drug.
  2. Next you will need to select National Select Formulary.
  3. Search for your prescription drug name on the list.

HIGHMARK COPAY ARMOR

Lion Traditional Participants Only – select specialty medication.

For participants in the Lion Traditional plan, Highmark utilizes a voluntary copay assistance program, called Copay Armor, to help reduce the cost of select high-priced specialty medications.

Copay Armor, powered by PillarRx Consulting, helps to leverage manufacturer assistance dollars to lower your out-of-pocket specialty prescription costs. The team at PillarRx works with you through personalized service. No matter what, your out-of-pocket costs will always be the same or less than what you’re currently paying. Upon enrollment in the Lion Traditional medical plan, participants should expect to receive a welcome letter in the mail as well as a phone call from PillarRx regarding enrollment in the voluntary program for select specialty medication.

Advantages of the Copay Armor program:

  • You’ll save money with manufacturer assistance — low to $0 out-of-pocket costs.
  • Copay Armor works at any in-network specialty pharmacy.
  • The PillarRx team is always there to assist you.
  • There is no additional cost to enroll in Copay Armor.

Please contact the Highmark Concierge Team with any questions regarding the Copay Armor program.

OTHER COPAY ASSISTANCE PROGRAMS

If you are enrolled in Lion Advantage or Lion Traditional and using manufacturer's discounts or incentives (outside of Highmark’s Copay Armor program), or services like GoodRx and SingleCare, please note that the amount you pay because of the discount will NOT be included in either your deductible or coinsurance maximums. Please contact the Highmark Concierge Team with any questions on using these types of services versus your Penn State health plan.

Contact

  • University Health Services (UHS) | 814-865-9321
  • Highmark Concierge Team | 844-945-5509

Mail Order Forms

 

Preventive Drug List

Lion Advantage - No Deductible, Coinsurance Only

Lion Traditional - Lower Coinsurance
View Preventive Drug List
Generic Drugs 10% coinsurance
Preferred Brand Drugs 20% coinsurance
Non-Preferred Brand Drugs 40% coinsurance
Lion Advantage Plan
Retail (30-day supply)
Generic Drugs 10% coinsurance
Preferred Brand Drugs 20% coinsurance
Non-Preferred Brand Drugs 40% coinsurance
Mail Order
Generic Drugs 10% coinsurance
Preferred Brand Drugs 20% coinsurance
Non-Preferred Brand Drugs 40% coinsurance
Specialty (Accredo)
Preferred Drugs 20% coinsurance, $65 Minimum
Non-Preferred Brand Drugs 40% coinsurance, $100 Minimum
Out-of-Pocket Maximum Integrated with Medical

 

Lion Traditional Prescription Coverage Technical Service Employees
Generic Drugs 50% coinsurance
Preferred Brand Drugs 50% coinsurance
Non-Preferred Brand Drugs 70% coinsurance
Mail Order
Generic Drugs 20% coinsurance
Preferred Brand Drugs 20% coinsurance
Non-Preferred Brand Drugs 70% coinsurance
Specialty (Accredo)
Preferred Drugs 50% coinsurance, $50 Maximum
Non-Preferred Brand Drugs 70% coinsurance, $100 Maximum
Out-of-Pocket Maximum $1,000/$6,000

Lion Traditional Prescription Coverage for Faculty and Staff

Pharmacy
Retail (30-day supply)
Generic Drugs 50% coinsurance
Preferred Brand Drugs 50% coinsurance
Non-Preferred Brand Drugs 70% coinsurance
Mail Order
Generic Drugs 20% coinsurance
Preferred Brand Drugs 20% coinsurance
Non-Preferred Brand Drugs 70% coinsurance
Specialty (Accredo)
Preferred Drugs 50% coinsurance, $50 Maximum
Non-Preferred Brand Drugs 70% coinsurance, $100 maximum
Out-of-Pocket Maximum $2,000/$8,000