Is there a Preferred Drug list?
Yes, under the Enhanced PPO Plan, the Value PPO Plan and the HSA PPO Plan, there is a Preferred Drug List (PDL). United HealthCare maintains the PDL. Click here for a copy of the most recent PDL. Your physician can prescribe any drug that has been approved for your condition and it will be covered unless specifically excluded in the Summary Plan Description. However, please see the table below to determine at which level the prescription will be covered.
| Network Provider | Non-Network Provider | |
|
Prescription Drugs (one month supply) |
Tier 1: 90% ($10 min/$20/max) Tier 2: 80% ($25 min/$45 max) Tier 3: 60% ($50 min/ $70 max) (Deductible does not apply) |
Not covered |
|
Mail Order Prescription (3 month Supply) |
Tier 1: 90% ($20 min/$40/max) Tier 2: 80% ($50 min/$90 max) Tier 3: 60% ($100min/$140 max) (Deductible does not apply) |
Not covered |
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