Prescription Drug Benefits

The CSA Welfare Fund provides Prescription Drug benefits to all active, in-service  members and their eligible dependents.

There are two parts to the drug benefit. The retail program is designed to be used when medications are immediately needed or are being monitored to achieve the correct dosage. The co-payment for medications purchased at a local pharmacy will be 10% for generic medications, 25% for preferred brand-name medications, and 35% for non-preferred brand name medications. If a medication is considered a maintenance medication taken for a chronic condition, it MUST be purchased through the mail after an original fill and 2 refills at a local pharmacy (3 fills in total). When filling a prescription at the local pharmacy, be sure to present your OPTUM Prescription card. The $50.00 per person/$150.00 per family annual deductible at the local pharmacy remains in effect.

The mail service program is designed to be used for medications needed to treat chronic conditions, such as high blood pressure or high cholesterol, which will be needed for an extended period of time. Medications purchased through Optum Home Delivery will cost $10.00 for generic medications, $25 for preferred brand-name medications, and $35 for non-preferred brand name medications. All prescriptions filled through the mail may be filled for a maximum of 60 days.

Specialty Medications that Must be Purchased from Briova
Medications that require a Prior Authorization
Medications with Quantity Limits 
Optum Direct Reimbursement Form

2022 OptumRx Formulary Drug List

 

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