University of Pittsburgh
Home › Benefits › Health and Wellness › Rx Program ›

Prescription Drug Program

University of Pittsburgh medical plans include comprehensive prescription drug coverage. Features of the prescription drug program include:

  • Mail-order pharmacy services
  • Maintenance prescription supply (90-day supply) discounts
  • Access to on-campus pharmacies

Prescription Drug Rider

The Prescription Drug Rider establishes the terms of coverage, member responsibilities, and policies and procedures to be followed in order for prescription drugs to be covered under your benefit plan.

Prescription drug coverage applies to all medical plans.

Prescription Tier Level Copayment ($) 30-day Retail Supply

Copayment ($) 90-day Maintenance Supply

Generic $12 $24
Preferred Brand $34 $68
Non-Preferred Brand $68 $136
Specialty $73 N/A

Please note that the prescription drug formulary is subject to change periodically based upon decisions by the UPMC Pharmacy and Therapeutics Committee. Examples include the introduction of new medications and changes in tier level (i.e., from brand name to generic).

Members may obtain a 90-day supply of medications at any participating retail pharmacy. However, three co-payments will apply, unlike when you obtain medications by mail order or at the Falk Clinic Pharmacy or Student Health Services Pharmacy. For example, at Student Health Services Pharmacy members pay $24 for a 90-day supply of generic medication, while the cost is $36 at a retail pharmacy.

Prescription Co-Payment Savings

  • Express Scripts mail-order services—Long-term maintenance medications may be obtained through the Express Scripts mail-order pharmacy. The University's prescription drug program allows you to receive 90-day supplies for most prescriptions while paying only two co-payments.
  • Falk Clinic Pharmacy—Falk Pharmacy, the flagship pharmacy of UPMC, offers a variety of services, including:
  • Student Health Services Pharmacy - The on-campus Student Health Services Pharmacy provides first-class pharmacy services to Pitt faculty, staff, and students. Services include:
    • Full prescription services
    • Over-the-counter medications
    • Unlimited patient counseling
    • 90-day prescriptions, for only two co-payments

UPMC Pharmacy Services

Through the UPMC Pharmacy Services Web site, you may:

  •  
    • Search to see if a particular drug is covered
    • Locate a pharmacy
    • Learn how to enroll in mail-order prescriptions
    • Download a Prescription Drug Claim Reimbursement form