Outpatient prescription drugs are covered under the UIGRADCare health plan through a separate Prescription Drug Plan. If you enroll in this plan, you must receive your medications from a Blue RX pharmacy (except in an emergency or when you are temporarily living out of Iowa) in order to receive coverage. Blue RX is a network of pharmacies. Check for pharmacy locations near you.
The UIGRADCare plan covers outpatient drugs routinely prescribed for common acute and chronic conditions. The cost of prescription medication depends upon what tier the drug is in. To find out what tier your medication falls under visit Wellmark’s drug formulary.
Some complex medical conditions may require the use of special injectable medications. In these instances, arrangements have been made so that coverage will occur under the medical portion of your health plan rather than through the Prescription Drug Plan.
For each prescription, you will pay: 25% co-insurance.
The pharmacy is responsible for submitting your prescription claims.
A convenient student pharmacy is located on the West Lawn Campus.
There is a $1,100 per year out-of-pocket maximum (OPM) for individuals and $1,700 for families for prescription drugs under UIGRADCare. Once the OPM has been met, the plan pays 100% of the expenses incurred for drugs during the rest of the calendar year. The OPM amount for prescription drugs is separate from the medical OPM.
Services Covered by the Prescription Drug Plan
- Prescription drugs (unless specifically excluded)
- Prenatal vitamins
- Prescription contraceptives and devices
- Prescription smoking cessation drugs
- Prescription drugs used as part of home health care services
- Insulin
- Disposable syringes and needles for the injection of insulin
- Glucose monitoring strips/lancets
Services Not Covered by the Prescription Drug Plan
- Prescription drugs received from a non-Blue RX pharmacy, except in an emergency or when temporarily living out of Iowa
- Most over-the-counter drugs
- Therapeutic devices and appliances, except disposable syringes and needles for the injection of insulin
- Nutritional supplements, including vitamins (except for prenatal vitamins)
- Investigational drugs labeled "Caution: Limited by Federal Law to Investigational use"
- Drugs not medically necessary for the treatment or prevention of illness, injury, or other covered condition
- Drugs used for cosmetic purposes (e.g., tretinoin (Retin-A) for treatment of skin aging, minoxidil (Rogaine) for stimulation of hair growth)
- Drugs dispensed by a person authorized to prescribe drugs (e.g., physicians, dentists and advanced registered nurse practitioners.)
- Drugs obtained outside the United States
- Charges for drugs covered by Worker's Compensation laws or other federal, state, or county programs
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