Preventive medication benefit coverage is provided before the deductible is met and the appropriate copay applies per Tier medication.
Your co-payment is determined by the tier to which the United Healthcare Preventive Prescription Medication Management Committee has assigned the medication product. All the prescription medications on the list are assigned to Tier 1, Tier 2, or Tier 3.
While the copayment doesn’t apply toward fulfilling a member’s deductible requirement, it provides the member with a valuable benefit by covering a portion of the cost of the preventive medications. The copayment does apply toward a member’s out-of-pocket maximum requirement.
These drugs serve an important role in treatment by supporting medication compliance and preventing possible adverse health events. There is supporting evidence that suggests the use of these medications can help lower the risk of adverse and costly events such as hospitalizations or Emergency Room visits.