Benefits Plans - Prescription Drug Plan
- Specialty drugs drive up costs of U-M prescription drug plan, The University Record, May 5, 2015
- Effective April 1, 2015, fluticasone nasal spray will no longer be covered.
Flonase Allergy Relief® was recently introduced as an over-the-counter (OTC) medication and is now available without a prescription. According to the university drug plan guidelines, OTC medications and prescription medications that are equivalent to OTC medications are excluded from coverage under the plan. Effective April 1, 2015, fluticasone nasal spray will no longer be covered. You may wish to discuss treatment options with your healthcare provider. If you require continued treatment on fluticasone nasal spray and you have a Health Care Flexible Spending Account (FSA), OTC Flonase Allergy Relief® may be reimbursable when you have a prescription from a health care provider.
- Breast Cancer Prevention
Under the Affordable Care Act, as of January 1, 2015, two oncology medications — tamoxifen and raloxifene — will be covered for use of breast cancer prevention at no out-of-pocket cost to U-M Prescription Drug Plan members.
- Proton Pump Inhibitor (PPI) Changes
Effective October 1, 2014, proton pump inhibitors (PPI) are no longer covered by the University of Michigan Prescription Drug Plan. More information.
U-M's drug plan holds costs, helps members save on co-pays, The University Record, April 7, 2014
- Infertility Medication Limits Changing Effective Jan. 1
Effective January 1, 2014, the U-M Prescription Drug Plan will cover a total of 5 prescriptions per lifetime per family of a select list of self-administered infertility medications. Other self-administered infertility medications are not limited to the 5 prescription lifetime family maximum. Most infertility medications are specialty medications and will be covered only when filled at U-M Health System Specialty Pharmacy Services, even if your doctor is not part of the U-M Health System. More information.
- All specialty prescriptions for U-M Prescription Drug Plan members must be filled by the University of Michigan Specialty Pharmacy.
Safe Medication Disposal
Be sure to dispose of old and unwanted medications properly to
The University of Michigan provides outpatient prescription drug coverage for faculty, staff, benefit-eligible graduate students, retirees, and their dependents enrolled in a U-M health plan through the U-M Prescription Drug Plan. The plan is administered by MedImpact HealthCare Systems, Inc.
This site contains comprehensive information to help you understand the policies and procedures of the U-M Prescription Drug Plan, explaining how to obtain prescription medication under the plan, and providing information for physicians.
- For changes to the drug plan, such as new drugs approved each month, view Drug Updates and New Releases.
- To find co-pay costs for a drug, view Costs and Co-Pays.
- To see if your prescribed medication is covered by the plan, view the U-M Formulary.
- Certain drugs have quantity limits and/or require special approval before they can be purchased through the plan. For a list of these drugs, see Coverage.
- For mail-order refills, go to the NoviXus Pharmacy Services website dedicated to U-M Prescription Drug Plan members: https://umich.novixus.com/.
- Log in to the MedImpact website for U-M members at https://mp.medimpact.com/umh to:
- Locate a network pharmacy near you
- Retrieve prescription drug co-pay estimates from any pharmacy within the MedImpact network
- View your secure medication history profile
- Check the status of your drug plan Prior Authorization(s)
What You Should Know about Pharmaceutical Copay Discount Cards
If you have a medical condition for which a blockbuster drug has been developed, chances are you have seen or used a discount card. Discount cards are typically offered to you at the time of your visit to the doctor’s office, as prescriptions are being written. The cards eliminate or reduce your copay amount so that you can use a brand-name drug at little or no cost.
These discount cards can dramatically increase the cost of the University of Michigan Prescription Drug Plan, which can result in higher premiums for you. The U-M drug plan encourages you to use generics, which are the equivalent to brand drugs. When a generic drug is available and your doctor feels it is the right choice for you, generics are the more cost-effective choice for you and the plan.
The next time you are offered a copay card for a specific brand name drug, ask your doctor if a generic drug is available. Affordability and overall cost are important to the U-M Prescription Drug Plan, and the decisions you make today will impact your cost in the future. By working together and making smart decisions, we can all help maintain the value and affordability of our pharmacy benefits in the future.
Notice for Medicare-Eligible Retirees
After careful review of the new Medicare Part D Plan, the University of Michigan strongly urges Medicare-eligible active employees (and their dependents enrolled in the U-M plan) NOT to enroll in Medicare Part D plan. You do not have to do anything in order to retain your current prescription drug coverage in the University of Michigan plan.
Overview of Plan Features
The Prescription Drug Plan provides coverage for FDA approved drugs prescribed by a physician, physician's assistant, or nurse practitioner up to a maximum of 90 days supply per fill, if your physician prescribes that amount.
The drug plan provides a consistent benefit and scope of coverage for all members. For example:
- Psychiatric drugs, oral contraceptives and devices, and smoking cessation products are covered for all participants.
- A convenient, secure mail order service, administered by NoviXus, offers delivery of a 90-day supply of medications to your home, office, or elsewhere in the United States.
- A website dedicated to U-M Prescription Drug Plan members for mail order refills is available at https://umich.novixus.com/.
All eligible participants who enroll in university health plans—active employees, retirees, and dependents—are automatically enrolled in the U-M Prescription Drug Plan.
Pharmacy Benefit Manager
MedImpact HealthCare Systems, Inc. administers the University of Michigan Prescription Drug Plan. Call MedImpact Member Service toll free at 1-800-681-9578. Telecommunications Relay Service (TRS) is available for persons who are deaf by dialing 711.
Show Your MedImpact ID Card When Filling Prescriptions
When your doctor writes a prescription for you, take it to a participating pharmacy and show the pharmacist your ID card from MedImpact. The pharmacist will confirm your enrollment in the U-M Prescription Drug Plan and fill your prescription at the appropriate plan co-pay. Temporary ID cards are available if needed.
Overrides for supplies larger than 90 days needed for extended travel outside the U.S. may be arranged by contacting the Benefits Office.
The University of Michigan in its sole discretion may modify, amend, or terminate the benefits provided with respect to any individual receiving benefits, including active employees, retirees, and their dependents. Although the university has elected to provide these benefits this year, no individual has a vested right to any of the benefits provided. Nothing in these materials gives any individual the right to continued benefits beyond the time the university modifies, amends, or terminates the benefit. Anyone seeking or accepting any of the benefits provided will be deemed to have accepted the terms of the benefits programs and the university's right to modify, amend or terminate them.