Pharmacy Insurance Plan - Part of the Student Insurance Plan

Eligibility

Students will be automatically enrolled in the University Health Center (UHC) Pharmacy Program when they enroll in the University of Nebraska Insurance Plan. This program will only be available to eligible students, dependents are not eligible for the pharmacy program unless they have purchased dependent coverage which will include the pharmacy premium.

Cost

The cost for the pharmacy program is $50 per year. This program allows participants to pay either a $10 copay for preferred products (generic) or a $25 copay for non-preferred products (brand names) from the UHC Pharmacy. A copay is the amount the patient is responsible for paying on each prescription. There is a maximum 30-day supply per copay. Inhalers (oral/nasal), topical preparations, ear, nose, rectal and eye products will be assessed one copay per container. The remainder of the prescription cost is absorbed by the program’s premiums.

The maximum allowance per person per year is $500. This amount is the total of prescription charges less the copay. This pharmacy program is not designed for catastrophic coverage. The maximum allowed has been designed to protect the majority of the plan participants from higher premiums and cover restrictions.

Coverage

This program is only available through the UHC Pharmacy. Patients will have the freedom and right, however, to take their prescription to the pharmacy of their choice. However, prescriptions filled elsewhere will not be covered under this pharmacy program.

Products used for the following purposes will NOT be covered: investigational or off-label used by the FDA, a cosmetic enhancement only, infertility or stimulating growth, immunization or as part of a transplant procedure. Also not covered are prescriptions paid by other programs such as worker’s compensation or Medicaid, injections, or brand name items where an AB-rated generic is available.

Patient Copay
Up to 30 day supply - generic	$10
Up to 30 day supply - brand name	$25
Up to 30 day supply - compounds	$25
Oral Inhaler	1 copay per container
Nasal Sprays	1 copay per container
Topical Preparations	1 copay per container
Ear, rectal, vaginal and eye preparations	1 copay per container

Medication Coverage
Serotonin 5HT, receptor agonists	limit 2 boxes per 30 days
Insulin, Humalog, Lantus, Novolog	covered
Diabetic Supplies (syringes, lancets, test strips, etc.)	covered by Chickering
Diabetic Devices (pumps, glucometers)	covered by Chickering

These are not covered by the program:

• Cosmetic Enhancement (Propecia, Accutane)
• Infertility
• Erectile Dysfunction
• Growth Stimulation
• Immunization (Typhoid, Lariam, Aralen, Malarone, vaccinations)
• Injectable Medications (other than insulin)
• Smoking Cessation
• Weight Loss
• Over-the-counter medications
• Prescriptions paid by other programs
• Brand name when generic is available
• Other drugs as determed by the pharmacy program