Express Scripts Platinum Plan with UHC

Prescription (Rx) Highlights (In-Network)

If you decide to enroll in one of the UHC health plans or the Surest Copay Plan, you are enrolled automatically in the Express Scripts Platinum Prescription Drug Plan. The plan covers both retail and mail-order prescriptions.

Express Scripts leverages Price Assure, powered by GoodRx, to automatically finds savings opportunities at your in-network pharmacy. Fill your prescription as you normally would, including showing your insurance ID card and the program applies the GoodRx available discount at the pharmacy without any action from you.

Prescription drug costs do not apply toward the UHC PPO deductible, but they do apply to a separate out-of-pocket (OOP) maximum ($2,000 individual; $4,000 family).

Prescription drug costs do apply toward the Enhanced and Base CDHPs deductible; however, there is a list of primary preventive medications that bypass the deductible, and you pay the applicable copay/coinsurance until you have met the annual out-of-pocket maximum. This list includes drugs that treat, for example, high blood pressure, high cholesterol, diabetes, and obesity.

In-Network

Retail (30-Day Supply)1

Retail & Mail Order (90-Day Supply)1

Generic

$10 copay ($10 max)

$25 copay ($25 max)

Formulary Brand

30% coinsurance
($35 min/$125 max)

30% coinsurance
($70 min/$250 max)

Non-Formulary Brand

50% coinsurance
($50 min/$150 max)

50% coinsurance
($100 min/$300 max)

Specialty

Not covered

20% coinsurance
(30-day max supply)

In-Network

Retail (30-Day Supply)1

Retail & Mail Order (90-Day Supply)1

Generic

$10 copay

$25 copay

Formulary Brand

30% coinsurance
($35 min/$125 max)

30% coinsurance
($70 min/$250 max)

Non-Formulary Brand

50% coinsurance
($50 min/$150 max)

50% coinsurance
($100 min/$300 max)

GLP-1 for Weight Loss2

30% coinsurance
($225 max)

30% coinsurance
($450 max)

Specialty

Not covered

20% coinsurance
(30-day max supply)

1. CDHP Plan members must first satisfy their plan deductible before the benefits in this chart apply, with the exception of some preventive medications, including GLP1s.
2. Effective January 1, 2026, the copay per script will increase for retail and mail order GLP-1 medications for weight loss, such as, but not limited to, Wegovy and Zepbound.GLP-1 medications for weight loss will continue to accumulate towards the plan out-of-pocket maximums. This change does not apply to GLP-1 medications associated with a diabetes diagnosis. We continue to evaluate the GLP-1 medications for weight loss coverage and may consider alternative strategies in the future. We will provide advance notice of any other changes.

More Information

Express Scripts

Call: 877-508-4866
Website: express-scripts.com/onemain

Learn More About Express Scripts

Additional Prescription Benefits

Express Scripts Mobile

Best for: comparing formulary coverage and alternatives, finding a pharmacy and viewing your digital ID card.

The Express Scripts mobile app and website helps you stay on track with taking your long-term medicines as prescribed. Long-term medicines are those used to treat conditions such as diabetes, high blood pressure and high cholesterol. With the app you can:

  • Quickly and easily manage your home delivery prescriptions—refill and renew them right from your phone with personalized reminders and notifications for when you are running low.
  • Look up potential lower-cost prescription options available under your plan and discuss them with your doctor.
  • Get personalized alerts if there’s a possible health risk related to your medicines. You can also add over-the-counter medicines, vitamins and supplements to check for possible interactions with your prescriptions.

Scripta Insights

Best for: medication comparison and finding savings through lower cost alternatives—ideal for those working with their doctor to develop a treatment plan.

In addition to your Express Scripts Platinum Drug Plan, OneMain is pleased to offer access to the Scripta Insights application. Scripta finds prescription medications that are the same or clinically equivalent to the ones you’re already taking, but at a lower cost to you. If you have an opportunity to save, you’ll receive a Personalized Savings Report that lists your current prescriptions and lower-priced options to discuss with your doctor.

Please note: prescriptions filled using your ESI benefit will apply to deductible and out-of-pocket expenses. If you opt to fill a prescription using the coupon or cash price feature, your expenses will not count towards your deductible or out-of-pocket expenses.

This benefit is only covered under the UHC medical plans and the Surest Copay Plan with your Express Scripts Prescription plan.

Smart90 Walgreens

Best for: obtaining long term, maintenance prescriptions in a 90-day supply through Walgreens pharmacies.

The Smart90 Walgreens program gives greater flexibility for team members to fill 90-day mail-order maintenance medicines at Walgreens at the same copay as Express Scripts. Team members can still continue to use mail order at Express Scripts.

Specialty Rx Needs

Best for: specialty medications; offers a 20% coinsurance and access to manufacturer copay assistance programs.

Rx Solutions Copay Program

Rx Solutions’ team of pharmacists manages a Specialty Copay Savings Program coordinated with Express Scripts. If you are taking specialty drugs, then you could qualify for copay assistance. All team members and dependents prescribed specialty medications will be contacted by the Rx Solutions team via US Mail to register for the program. Upon receipt of the letter, members must contact Rx Solutions at 888-201-9175 to enroll in the available program through the medication’s manufacturer.

Accredo Specialty Pharmacy

Accredo, an Express Scripts specialty pharmacy, is a full-service pharmacy that provides home delivery service for Specialty Drugs. Accredo offers therapy-specific teams that provide an enhanced level of personalized service to patients with special therapy needs. For more information or to order your specialty medications, visit accredo.com or call 800-803-2523.

ImpaxRx

Best for: helping individuals access high-cost medications at no cost with patient advocates to guide through applications for manufacturer assistance programs for eligible medications.

ImpaxRx can dramatically reduce high-cost specialty medication expenses incurred for you and your family. If you or other family members have been prescribed any High-Cost medications an ImpaxRx program advocate will reach out to you to determine if you qualify to receive your high-cost medications at no cost to you.

When you are contacted by an ImpaxRx Advocate, please be ready to answer a few simple questions to determine if your high-cost prescription medication qualifies you for program savings. If qualified, you will be asked to enroll in a Medication Under Management (MUM) program so you can start receiving your medications uninterrupted directly delivered to your home or local pharmacy.

If you have questions, please contact ImpaxRx at 844-467-2979, option 1.

View Helpful Contacts

You've got questions? We've got answers.

The Benefits Service Center is made available to you through the HRConnect Self-Service Portal, providing support from dedicated professionals committed to helping you understand the benefit options available to you. Whether you have questions about your benefit plans, concerns about coverage, or just need guidance on which medical plan is right for you and your family, connect with the Benefits Service Center.

Contact HRConnect