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SAS pharmacy benefits

Let us help you learn more about your prescription drugs. You can look up your prescription drugs and learn how much you will pay for them. Or locate a network pharmacy near you.

Get to know your prescription drug coverage

You get the most value out of your pharmacy benefit by understanding the medications covered under your plan. Take time to understand how your  pharmacy benefit works  and how you can lower your out-of-pocket prescription costs.  You can find out more about your benefits by looking at your plan's Summary Plan Description. To check how much you will pay for your prescriptions, see your list of covered drugs (formulary).

Find your drugs with our online search

Use the interactive formulary above to look up the medications you take.   The list of covered drugs under your plan is called a  "formulary". Our team of on-staff physicians and pharmacists reviews information on new and existing drugs and regularly updates the formulary with drugs that are safe and effective. Our interactive formulary is updated by the fifth business day each month.

Drug tiers explained

  • Tier 1: most generics - drugs covered at the lowest cost share and will cost you the least.
  • Tier 2: preferred brands and select generic drugs
  • Tier 3: non-preferred brands and select generic drugs
  • Tier 4: specialty drugs and some very high cost brand/generic drugs
  • Preventive Benefit: preventive drugs, $0 cost sharing.

Importance of generics 

In most cases, you will save money by using generic drugs when they are available. If you request the brand name product for a medication when a generic is available, you must pay the applicable copayment or coinsurance plus an ancillary charge. The ancillary charge is the cost difference between the brand name product and the generic product. The ancillary charge will not count toward your out-of-pocket limit for prescriptions.

How to request an “exception” for your prescription drug. 

Sometimes a drug you have been prescribed is not on our formulary. You may request a formulary exception (also called a medical exception) to receive coverage for a non-formulary prescription drug or medical supply.   To learn more about the prescription drug coverage exception process and how to initiate a pharmacy exception, click here. 

To initiate an exception process via email, click here. The request should include:

Medication therapy management

Talk with a pharmacist who can help you find ways to:

  • minimize or eliminate medication side effects
  • reduce the number of drugs you take
  • find lower-cost alternatives

Opioid management

Opioids relieve moderate to severe pain but can have side effects and serious risks. Safety measures help reduce opioid use.

Self-help tools

Web access and tools to provide drug pricing transparency, alternative drugs, history of drug claims and side effect information

Compounding pharmacies

A compounding pharmacy makes drugs prescribed by doctors for specific patients with needs that can't be met by commercially available drugs. Here is a list of affiliated compounding pharmacies that will submit claims to us online and accept our reimbursement. View the list of affiliated compounding pharmacies.

Mail order pharmacies

Members of Security Health Plan have the option of getting their prescriptions through the mail using MedImpact Direct. Using this mail order pharmacy service for covered medications and supplies or for discounts on other prescriptions can be convenient but is not required. Using MedImpact Direct is completely voluntary. Members may continue to obtain their medication from any affiliated pharmacy. To access MedImpact Direct please click here.

Resources

MedImpact Direct - Medication Mail Order Form
2021 Commercial diabetic formulary
2021 Choice Diabetic List
2021 Essential Health Benefit Preventive Drug List for Affordable Care Act/Marketplace plans
2021 Preventive drug list

Prescription drug reimbursement request
Drug Safety News
New rules for pain medications