Your co-payment and coverage schedule are described in your health plan documents. If there is a generic equivalent available and a brand name (preferred or non-preferred) drug is dispensed, you may be responsible for the respective brand co-payment plus the cost difference between the generic and brand name drug. You can confirm your drug plan type by referring to your member ID card, asking your Plan Administrator, or contacting HWMG.
The amount you pay for a covered drug will depend on your coverage tier. Each covered drug is in one of several tiers. Each drug’s tier amount may be different. Each drug tier may have a different copayment or coinsurance amount. Please refer to your health plan documents for additional information. To find out the cost of your drugs, you may contact OptumRx toll-free at 1-800-880-1188.
In your prescription plan, the formulary drug list is used as a guide for determining your co-payment for each prescription, with drugs listed on the formulary typically available at a lower co-payment. However, only you and your doctor can decide which medications are right for you. Review the list carefully, and note it is not all-inclusive and is subject to change.
For HMAA and Charter Communications, our formulary is updated on January 1 and July 1. By making updates twice a year, we are able to keep pace with current market trends, price changes, and new clinical information.
- Effective July 1, 2024 through December 31, 2024:
You may also view the following:
You can request convenient, cost-effective delivery of prescription drugs right to your door through OptumRx home delivery service. You may register online and submit orders 24 hours a day, 7 days a week through the OptumRx member portal or via their mobile app, or print and complete the Mail Order Prescription Form.
With our Step Therapy Program, you can receive the most cost-effective covered medications for various drug categories as early as possible in your treatment plan.
Our Opioid Risk Management Program aims to minimize your exposure to risks associated with misuse, abuse, and addiction to opioids.
If your health plan offers this program, our Member Advocates will assist you with identifying and enrolling in Copay Assistance Programs funded and supported by drug manufacturers. If eligible, HWMG will work with you to maximize utilization of these programs to lower the cost of your covered medications, which is ultimately shared by you and your health plan, without compromising the treatment you need. Please verify with your health plan administrator that this program is available to you.
Our pharmacy benefit manager, OptumRx, provides free online access to help manage your prescriptions. Once you are registered, you can learn more about your prescription benefits and obtain maintenance medications through home delivery.
Optum Perks offers free direct, individual pharmacy discount cards. You and your family will enjoy special savings on select prescription medications. There are no membership or fees for the card.
Offered through HWMG’s Member Plus Discount Program, you can obtain the free discount card online and instantly save up to 80% on select prescription medications at thousands of participating pharmacies nationwide. If you already have insurance through a carrier other than HWMG or HMAA, please bring both your insurance card and this discount card to your pharmacist to see which provides a more cost-effective option for you.
