Prescription Benefit Information for the Faculty & Staff of the University of Toledo
Complete information containing the 2015 Main Campus & Health Science Campus benefit plan descriptions can be found on the Human Resource Office's Benefits web site. This site includes:
- Links to the Full Formulary, the Preventive Drug List, and Specialty Medications found under the pharmacy section
- Links to each campus and union's premiums and plan designs
- Dental and Vision coverage information
Other useful links:
Information Common for both Prescription Benefit Packages
The University of Toledo’s medical plans include prescription drug benefits through SXC (now Catamaran).
Using This Benefit
Catamaran offers prescription drug benefits through your University of Toledo Pharmacies offering a 90 day supply and retail pharmacies offering a 30 day supply. There are four categories of prescription medications:
1. Tier 1 (Generic Drugs)
Generic drugs are FDA-approved drugs containing the same active ingredients as their brand-name counterparts. Generic drugs often provide you with a cost savings over their brand-name equivalents. Discuss with your health care professional any medical or financial advantages of using generic prescription drugs.
2. Tier 2
Tier 2 is preferred drugs that include select brand-name medications chosen for their clinical effectiveness, safety profiles, and lower costs. The University of Toledo Prescription Drug Formulary is evaluated as new therapies are introduced or when drug patents expire and new generics become available. A listing of the UT employee Prescription Benefit Formulary can be accessed at the Benefits website. Learn about formularies online at https://utr.rxportal.sxc.com , compare prescription costs, and view potential drug alternatives for any medication. This tool helps you determine the most cost-effective way to purchase your medication. Catamaran has fully trained representatives to assist you with all your benefit and claim processing questions. Representatives are available 7 days a week, 24 hours a day. Please call the toll free telephone number at 1-800-325-1810 or visit the Catmaran web site at https://utr.rxportal.sxc.com.
Brand-name drugs not approved on the UT formulary list due to efficacy or cost concerns.
4. Specialty Medications
Usually high-cost pharmaceutical products, those are generally, but not exclusively, biotechnological in nature. These medications are commonly used to treat chronic conditions and are typically injectable, may require refrigeration, special handling/delivery, and/or distinct safety protocols. A complete listing of specialty medications can be found here. Prior authorization may be required for specialty medications. Once approved, the authorization is valid for up to one year. If a prescription drug requiring prior authorization is not approved for coverage under the plan, you will be responsible for paying the full cost of the medication. Your University of Toledo Pharmacist will discuss and assist you with any prior authorization needs.
How to fill specialty drugs at The University of Toledo Outpatient Pharmacies:
- Prior authorization may be required for some specialty drugs. The pharmacist will contact your physician directly to begin the process.
- Please keep in mind that this process may take up to 2 weeks to be finalized.
- Bring your prescription for your specialty drug to the pharmacy and we will take care of the rest.
- Keep in mind; you have the opportunity to obtain better co-payment options by filling your specialty prescription at one of the University of Toledo Outpatient Pharmacies.
- If a drug is only available through a limited distribution pharmacy that is not part of the specialty pharmacy network, contact the UT pharmacy staff who will direct you to the appropriate care.
- Due to high side effect potential, we encourage you to fill a one-month supply of your specialty medication, especially if it is your first time filling this particular medication.
Ways to Reduce Your Prescription Drug Costs:
1. Choose generic versions of medications which were previously brand-name prescription drugs (i.e. Paxil, Claritin, Zyrtec, etc.). Generic medications (such as simvastatin) provide the least expensive co-pay opportunity for you. From quality and performance to manufacturing and labeling, generic medications meet FDA high standards for quality of care.
2. Use one of the University of Toledo Outpatient Pharmacies. You can receive a 90-day supply with a value added co-payment by simply using one the University of Toledo Outpatient Pharmacies.
3. Half Tablet Therapy is a voluntary pill-splitting program that is offered by your University of Toledo Outpatient Prescription Drug Plan since September 1, 2008. This voluntary pill-splitting program gives patients the opportunity to save money. Members who participate in this program will receive a reduction in their co-pay. In addition, the University will provide one pill-splitting device per year. Experts have discovered trends in pricing structure of these cholesterol-lowering agents. Here is how you can save money. Have your provider write a prescription for double your strength of Lipitor or Crestor and you can take half of the tablet (of this higher strength medication) to match your current dose. For more information regarding these saving opportunities, please contact one of the University of Toledo Outpatient Pharmacy locations:
Main Campus Phone: 419-530-3471
Health Science Campus Phone 419-383-3750