Your Health:

Prescription Drug

Introduction

Marathon Petroleum’s prescription drug coverage for both Health Plan options is administered by Express Scripts. You will automatically receive prescription drug coverage if you enroll in either Health Plan option.

Prescription Drug – Overview

Your prescription drug costs will depend on the Health Plan option you elect, whether you purchase at a retail pharmacy or through mail order, and the type of prescription drugs you buy (i.e., generic or brand name). The plan also covers certain preventive drugs and immunizations at 100% when obtained in-network. All prescription and specialty drugs MUST be purchased through Express Scripts mail order pharmacy or at a participating network pharmacy, or there will be no coverage from the plan.

Retail Overview

For retail medications, your prescriptions must be filled at an Express Scripts network pharmacy.

Generally, you should use retail pharmacies to purchase up to 30-day supplies of new prescriptions or medications you expect to take on a short-term basis. Ninety-day supply programs are more cost effective for both you and the Company, so the plan encourages appropriate use by limiting the number of 30-day fills of a maintenance drug. To encourage the use of mail order or Smart90-Walgreens, there will be no coverage for the 3rd and subsequent fills of a maintenance drug not purchased through one of these 90 day supply options. You will pay 100% of the cost of the medication. The amount you pay will not be applied to your deductible or out-of-pocket maximum.

Mail Order Overview

If you take medications on an ongoing basis for chronic conditions, they are classified as maintenance drugs and you should purchase a 90-day supply from the Express Scripts mail order pharmacy.

If your doctor is prescribing a maintenance drug, you should ask for two prescriptions – one for a 30-day supply to fill at retail (so you can start your medication right away) and one for a 90-day supply with three refills.

Smart90-Walgreens Overview

As an alternative to the mail order pharmacy from Express Scripts described above, you can choose to get your maintenance medications supplied through a Walgreens pharmacy. The document below has details regarding this program that may answer some of your questions.

Prescription Drug Coverage Chart

Prescription Drugs – All Options
  Classic Option Saver HSA Option
Out-of-Pocket Maximum Combined with medical
Prescription Annual Deductible Retail Only — $100 Individual; $200 Family Combined with medical

Retail (30-day supply):

  • Generic Drugs
  • Preferred Brand Drugs3
  • Non-Preferred Brand Drugs3

 

  • $10 after deductible2
  • $30 after deductible2
  • $60 after deductible2
You pay 20% after deductible1

Maintenance Drugs4 – 3rd and subsequent fills

You pay 100%5 You pay 100%5

Mail Order (90-day supply):

  • Generic Drugs
  • Preferred Brand Drugs3
  • Non-Preferred Brand Drugs3

 

  • $252
  • $752
  • $1502
You pay 20% after deductible1

Smart90-Walgreens (90-day supply) retail deductible applies:

  • Generic Drugs
  • Preferred Brand Drugs3
  • Non-Preferred Brand Drugs3

 

  • $25 after deductible2
  • $75 after deductible2
  • $150 after deductible2
You pay 20% after deductible1

1 Certain generic preventive drugs under the Saver HSA option are covered at 100%. A list of these drugs can be found here.

2 If the total cost of a drug is less than the copay, your cost will be the total cost (e.g., if the total cost of a generic drug at retail is $4, you will pay $4 instead of the $10 copay).

3 If you purchase a brand-name drug when a generic is available, you will pay the cost of the generic drug plus 100% of the difference in price between the generic and brand-named drug.

4 To encourage the use of mail order or Smart90-Walgreens, there will be no coverage for the 3rd and subsequent fills of a “maintenance drug” purchased in 30-day supplies at a retail pharmacy. You will pay 100% of the cost of the medication.

5 The amount you pay will not be applied to your deductible or out-of-pocket maximum.

Preventive Drugs and Immunizations

Preventive Medications Covered Under Both Plan Options

The plan covers many preventive medications and immunizations at no cost to you when provided by or obtained through an Express Scripts in-network pharmacy. These include generic drugs and, in some cases, brand-named drugs, along with some over-the-counter (OTC) medications. However, for eligible OTC medications to be covered at 100%, you must have a prescription.

Preventive Medications Covered at 100%

Generic contraceptives

  • Coverage is available for brand-named contraceptives, subject to deductible and coinsurance.

OTC aspirin for adults up to age 60 (prescription required)

OTC iron for children under age one (prescription required)

Fluoride for children through age 5

OTC folic acid for females through age 50 (prescription required)

Prescription and OTC (prescription required) smoking cessation products for adults age 18 and over, limited to 180 days of medication per year

  • Coverage is available for smoking cessation products for those under age 18, but is subject to prescription requirement and applicable deductible and coinsurance.

Preventive vaccines and immunizations – based on recommendations of the Centers for Disease Control and Prevention (CDC). Some age restrictions may apply and are subject to change by the CDC. If you have questions as to whether a vaccine will be covered at 100%, contact Express Scripts at 1-877-207-1357.

  • In most cases, vaccines are provided and administered at your doctor’s office and the claim would be processed and paid by Anthem under the medical provisions of the MPC Health Plan.

Additional Preventive Medications Covered Under the Saver HSA Option

For employees who elect the Saver HSA Health Plan option, prescription drugs on the list below are covered at 100% by the plan regardless of deductible.

More Important Information