Prescription Drug
You or one of your family members will likely need medication at some point during the year. It’s important to understand your prescription drug plan to make the most of your benefits.
Maximize Your Pharmacy Benefits
When you enroll in a ZOLL medical plan, you automatically receive prescription drug coverage through OptumRx.
All plans offer three Tiers of Prescription Drugs.
- Tier 1: Generic prescriptions are just as effective as name brand drugs at a fraction of the cost.
- Tier 2: Preferred Brand prescriptions offer great value for a slightly higher cost.
- Tier 3: Non-Preferred Brand prescriptions cost the most out of pocket.
The plans differ in your out-of-pocket costs. Refer to the Prescription Drug Plan Comparison below.
The Patient Protection and Affordable Care Act (PPACA) Drug List is a federally mandated list of medications free of cost to help prevent disease as well as meet unique health care needs. These drugs are at $0 cost regardless of which plan you are enrolled in.
The 2025 Preventive Drug List for Consumer Driven Health Plans provides a list of prescription medications considered “Preventive” under the Saver Plan with HSA. Drugs on this list are not subject to the deductible. When comparing your plan options, be sure to see if any of your preventive medications are included in this list – it may save you money!
| Prescription Drugs – OptumRx – Plan Highlights | ||||
|---|---|---|---|---|
| Plan Feature | Retail Pharmacy (30-Day Supply) |
Home Delivery/Mail-Order (90-Day Supply) |
||
| Surest Plan | Saver Plan with HSA* or PPO Plan |
Surest Plan | Saver Plan with HSA* or PPO Plan |
|
| PPACA Drug List | $0 | $0 | $0 | $0 |
| Preventive Drug List for CDHP Plans | N/A | Saver Plan with HSA – Copay PPO Plan – N/A |
N/A | Two copays |
| Tier 1 | $5 | $10 | $15 | $20 |
| Tier 2 | $40 | $30 | $100 | $60 |
| Tier 3 | $60 | $45 | $150 | $90 |
| Applies to the plan out-of-pocket maximum | Yes | Yes | Yes | Yes |
* After deductible has been met
You can fill your prescriptions at a Retail Pharmacy or through Mail Order. To maximize your savings, follow this guide:
| If your prescription is | Fill your prescription at |
|---|---|
| Short-Term Prescription (30-Day Supply) | Nearest Retail Pharmacy |
| Maintenance or Long-Term Prescription (90 Day-Supply) | Mail-Order Pharmacy |
Maintenance medications are those you take to manage a chronic condition, such as high cholesterol or diabetes. You will receive three months of medication for the cost of two months’ worth of copays. Even better, the medication will be delivered right to your home. Shipping is free.
NEED MORE INFORMATION ON THIS BENEFIT?
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