Using your prescription coverage

What's covered?

Medication is a critical part of many treatment plans. But it can be really expensive! That is why it is so important to have prescription coverage.

You will be happy to hear that prescription drugs are now a covered benefit for our members and include most FDA-approved medications.

HAP is always reviewing new medications introduced to the market and may add or remove items on our drug formulary. A formulary is a list of covered prescription drugs. Prescription drugs are self-administered drugs that you can obtain from pharmacies and that you use in the outpatient setting.

Drug Search

How much is covered?

HAP uses a four tier prescription cost-sharing system. Refer to the Summary of Benefits and Coverage (SBC) for Plan specific cost-sharing information. Generic medications usually have the smallest cost-sharing amount.

Tier 1 - Generic Rx: most generic covered prescription drugs
Tier 2 - Preferred Rx: select brand prescription drugs
Tier 3 - Non Preferred Rx: brand prescription drugs with lower cost alternatives
Tier 4 - Specialty drugs

If an FDA-approved generic drug is available, your pharmacy will use the generic form of the medication.

The standard one month supply of a prescription drug is up to a 30-day supply. A 90-day supply can be obtained through HAP’s Mail Order pharmacy. Specialty drugs, injectable drugs (except insulin) and select oral drugs (e.g. opioid analgesics) are limited to a maximum 30-day supply per fill. Some specialty drugs require a 15-day first fill.