PRESCRIPTION DRUGS
Resources
When you select a Southwest medical plan, you’re automatically enrolled in our prescription drug plan. Your prescription coverage is managed by SmithRx. You have three ways to get your prescriptions filled.
SOUTHWEST GENERAL PHARMACY
Purchase a 31-day or 90-day supply of maintenance drugs through Southwest General Pharmacy. If you utilize Southwest for your prescription needs, you will have a lower deductible and cost share under the PPO plans.
RETAIL (NON-MAINTENANCE MEDICATIONS)
Use SmithRx’s nationwide network of more than 85,000 participating pharmacies for up to a 31-day supply. Locally the following are still in-network: Southwest General Pharmacy, CVS, Walmart and Costco.
BY MAIL*
Order a 90-day supply through Amazon Pharmacy. Enroll online at www.amazon.com/smithrx and click on ‘Get Started’.
Prescription mail-order service is managed Amazon Pharmacy. Enroll at www.amazon.com/smithrx and click on ‘Get Started’.
Take advantage of the preventive drugs covered by our plan at $0 under all 3 medical plans.
Effective January 1, 2018 under all Southwest health care plans maintenance medications must be filled through the Southwest Community Pharmacy or via mail order with Postal Prescription Solutions. Prescriptions filled through the Southwest Community Pharmacy will have a lower deductible and lower cost sharing under any of the Southwest PPO plans. Note, HSA plan participants will pay the full cost of prescriptions until the deductible is met. Maintenance medications are any medications with two or more fills.
Note: When a member requests a brand name drug with a generic available, the member will be charged the difference in the cost between the brand and the generic drug plus the brand copay.
Step Therapy: A step therapy program uses an automated process to determine whether you qualify for coverage based on information we have on file, such as medical history, drug history, age and gender. This program requires that you try another drug before the target drug can be covered by your plan, unless special circumstances exist. If your doctor believes that special circumstances exist, he or she may request a coverage review. For a listing of drugs in the step therapy program, contact your prescription benefit company.
*Prescription mail-order service is managed by Postal Prescription Solutions. Enroll online at www.ppsrx.com or call 800-552-6694 to enroll by phone.
** Smoking cessation prescriptions are included in your normal deductible. Participants of Southwest General Wellness may be eligible to receive additional smoking cessation benefits.
