Prescription Drug Benefits

2020 Plan Year Information

Prescription Drug Coverage

The Morgan Stanley Medical Plan includes prescription drug coverage. If you elect Medical Plan Option A, B or C administered by UnitedHealthcare (UHC) or Medical Plan Option A or B administered by Cigna, your prescription drug coverage is administered by OptumRx. If you elect Medical Plan Option C administered by Cigna, your prescription drug coverage is administered by Cigna Pharmacy Benefits.*

Options A, B and C all generally cover the same prescription drugs. The major difference in prescription drug coverage is the annual deductible required before the coinsurance begins to share the cost of prescription drugs.

*If you participate in a regional Medical Plan option in California or Hawaii, prescription drug coverage is provided through the Medical Plan administrator. Please contact the Plan administrator or visit its website for information about prescription drug copays, preferred drug or formulary lists and managed drug programs.

If You Enroll in Option A or B: In-Store (up to 30-day supply)If You Enroll in Option A or B: Mail Order (up to 90-day supply)If You Enroll in Option C: Preventive MedicationsIf You Enroll in Option C: Non-Preventive Medications
First

You Must Pay Your Deductible

Annual Deductible
  • Single: $50
  • Family: $150

None, skip to coinsurance

Medical and prescription drug deductibles are combined; skip to coinsurance for payment amounts for prescription drugs

  • Single: $2,300
  • Family: $4,600

Medical and prescription drug deductibles are combined; skip to coinsurance for payment amounts for prescription drugs

  • Single: $2,300
  • Family: $4,600
Annual Deductibles

The annual deductible works differently depending on the Medical Plan option you choose. The Option A and B annual deductible is for your prescription drugs only (a separate annual deductible applies for medical costs); the Option C annual deductible includes medical and prescription drugs.

Combined Medical and Prescription Drug Deductible

Under Option C, your non-preventive prescription drug costs count toward your deductible and out-of-pocket maximum amounts. So, if you are prescribed a non-preventive prescription drug early in the year, it is possible you’ll receive a bill as high as $2,300 for single coverage or $4,600 for family coverage. If you are enrolled in family coverage, you must meet the family deductible amount before the plan will begin to pay benefits for all non-preventive drugs and services.

If you have a condition requiring regular, high-cost medications, you may want to consider Options A or B.

Note: Preventive drugs are generally prescribed for people who may be at risk for certain diseases or conditions. This does not include drugs or medicines for treatment of an existing illness or condition.

View the current Cigna and UnitedHealthcare preventive prescription drug lists on the Cigna or UHC websites.

2020 Cigna Rx No Cost Share Preventive Drug List

2020 Cigna Rx Formulary Drug List

2020 UHC OptumRx Formulary Drug List

In-Store (up to 30-day supply)Mail Order (up to 90-day supply)
Then

You Pay Coinsurance

Generic Drugs

You pay $10 copay

You pay $20 copay

Preferred Brand Drugs

You pay 30% coinsurance
($25 min, $50 max)

You pay 30% coinsurance
($25 min, $75 max)

You pay 30% coinsurance
($63 min, $112 max)

You pay 30% coinsurance
($65 min, $150 max)

Non-Preferred Brand Drugs

You pay 40% coinsurance ($50 min, $150 max; $200 max for specialty drugs*)

You pay 40% coinsurance ($125 min, $300 max; $400 max for specialty drugs*)

* Please note that specialty drugs will have increased coinsurance maximums in 2020.

Mandatory Mail Order

If you are prescribed a maintenance medication you must get a 90-day supply through mail order delivery or a participating retail pharmacy.

  • Enrolling in Mail Order or Retail 90 is easy and it saves you time and money – and you reduce the risk of having a lapse in your treatment.
  • Maintenance medications are any preventive prescriptions you take on an ongoing basis, such as medications for high blood pressure, high cholesterol or birth control.
  • After three fills at a retail pharmacy , if you do not enroll in Mail Order or Retail 90, you will have to pay 100% of the cost of the medication starting with the 4th refill.
    • The amount you pay will not count toward your deductible or out-of-pocket maximum.
    • You will continue to pay the full cost of the drug until you enroll in Mail Order or Retail 90.
  • If you currently take a maintenance medication or are prescribed one at any point, you will be notified by Cigna Pharmacy or OptumRx.

Ways to Save on Prescriptions

Use Generics

  • They have the same active ingredients as brand-name medications
  • Choosing a brand-name drug when a generic is available means you will pay the cost of the generic, plus the difference between what the Plan would have paid for the generic and the cost of the brand-name drug
  • The additional cost will not apply toward your annual deductible, but is included in your out-of-pocket maximum

Use a Preferred Brand-Name Drug

  • You pay less than you would for a non-preferred brand-name drug (but you still pay still more than would for a generic, if available)

Contact OptumRx or Cigna Pharmacy Benefits

  • Find out how much you can save with available drug-pricing tools
  • Sign up for any of the following for your maintenance medications:
    • OptumRx Mail Service Saver Plus
    • CVS Saver Plus
    • Cigna Home Delivery Pharmacy
    • Cigna 90 Now
  • View the current formulary or approved drug lists and the preventive drug lists

You may continue to fill your maintenance prescriptions at a retail pharmacy, but will lose the benefit of any Plan coverage or pricing discounts available through the home delivery program. You will pay the full cash price at the retail pharmacy after your third fill, less the amount of any coupon/copay credit that your pharmacy will accept. Before purchasing at a retail pharmacy, we encourage you to compare prices by calling OptumRx and your retail pharmacy. Often the mail order cost is less than the retail pharmacy’s cost, even after subtracting the coupon or copay discount.

Prescription Drug ID Cards

UHC Medical Plan Options A, B and C

Participants will receive a single ID card for both medical and OptumRx prescription drug services.

Cigna Medical Plan Options A or B

Participants will receive separate medical ID and OptumRx prescription drug cards.

Cigna Medical Plan Option C

Participants will receive a single ID card for both medical and Cigna Pharmacy Benefits prescription drug services.

Need additional ID cards?

You may print additional cards on the OptumRx or Cigna website, or by calling the number on the back of your card to request additional cards by mail.