Broker Broadcast
Specialty Medication Plan Offers Competitive Pricing and Better Choices
New pharmacy plans will feature coinsurance for certain injectable specialty medications beginning Jan. 1, 2010. This change will align UnitedHealthcare with competitors while providing your clients with better cost-management options. Plan designs will be available for both the UnitedHealthcare and PacifiCare SignatureEliteSM Plus product lines.
The Specialty Medication plan design is the administration of separate coinsurance for certain specialty medications. This provides members with coverage for important medications, while helping keep employers' overall costs low.
The designs feature eight new pharmacy options, among them:
- New, more-affordable plans with $15 and $20 Tier 1 copays.
- New deductible options that waive the deductible when members fill their prescriptions with the more cost-effective drugs classified in Tier 1, which creates value for our members. And for those clients looking for a lower premium alternative, the savings can be significant.
Competitive Pricing
Currently, UnitedHealthcare has a lower member cost share for specialty medications than their competitors. Although less than 1 percent of our members need specialty medications, aligning their specialty medication cost share with their competitors will lower the utilization of specialty medication and create a more price competitive model.
The New Specialty Medication Plan Design:
- Maximizes the spread between tiers to help incent the member to use a lower tier alternative when available, which keeps overall premium rates lower.
- Employers have more affordable healthcare coverage, better cost management options, and better employee medication decisions.
- Provides employees with comprehensive specialty medication access, integrated clinical team support, and access to complete information on pharmacy benefits options and costs.
- Continues UnitedHealthcare's commitment to health care programs that better meet the needs of employers and plan members who entrust them with their health coverage.
Please Note: With the launch of the new lower-priced plans on Nov. 16, 2009,
the existing pharmacy offerings will no longer be available for new groups with 2-50 eligible employees with effective dates of Jan. 1, 2010 and later. New groups with 51-99 eligible employees may select a pharmacy plan from the new plans, or they may continue to use the current plans.
If you have any questions, please contact your TIE sales or renewal representative at (972) 991-6500
Specialty Medications
Drug List
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