Thrifty White Stores
Employee Pharmacy Benefits
Your plan includes coverage of prescription drugs and a range of options for filling
your prescriptions. Covered drugs are shown on the Medica Preferred Drug List
(PDL), which is comprised of drugs that provide the most value and have proven
safety and effectiveness. This helps keep your share of the costs at their lowest.
The PDL contains both brand-name and generic drugs, and is reviewed and updated
regularly by an independent committee of physicians and pharmacists. Your doctor
can use this list to choose medications for your health care needs, while helping you
get the most value from your prescription drug benefit.
PREFERRED DRUG LIST TIERS
Medications on the PDL are placed into tiers. These tiers determine your out-ofpocket costs, with Tier 1 having the lowest copayment or coinsurance. To view the
PDL, log in to mymedica.com and choose Pharmacy Resources.
BENEFITS OF USING THRIFTY WHITE PHARMACIES
Lower Prescription Costs
Under Thrifty White’s Medica insurance plan, you’ll pay less for prescription drugs
when you fill your prescriptions at a Thrifty White pharmacy. Use Thrifty White’s
Ready Refill and Med Sync programs to improve you medical adherence and health.
THINGS TO KNOW BEFORE FILLING PRESCRIPTIONS
Some medications have special requirements or limitations, which are noted on the
PDL as follows:
Prior authorization (PA): Your doctor must request approval from Medica for you
to receive coverage for this drug.
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QUESTIONS ?
Call one of our
Health Plan Specialists at
952-945-8000 or
1-800-952-3455.
We’re here to help!
MYMEDICA.COM PROVIDES
INFORMATION YOU NEED
Log in to mymedica.com and
choose Pharmacy Resources to:
Find a pharmacy in Medica’s
network
View Medica’s PDL, Specialty
Drug List and information
about tiers
Print an abridged PDL to bring
to your doctor appointments
Review your prescription history
Information on mymedica.com may
not reflect all the details of your
plan’s unique pharmacy network
or benefits with Thrifty White
Stores. Call us at 952-945-8000
or 1-800-952-3455 for additional
information about your plan.
Step therapy (ST): Before receiving coverage for this drug, you must first try one
or more alternative drugs that are more cost effective.
Quantity limits (QL): The maximum quantity allowed per prescription for a specific
period of time.
DEFINITIONS
Brand-name drugs: Drugs
protected by a patent for a certain
amount of time. Once the patent
expires, generic versions are often
introduced.
SPECIALTY DRUGS
Some medications are considered specialty drugs. These drugs are typically used
to treat certain complex diseases. Log in to mymedica.com to see a list of drugs that
are considered specialty medications. Prescriptions for these drugs must be filled
through Thrifty White Pharmacy or one of Medica’s designated specialty pharmacies
listed below (unless otherwise indicated on the specialty drug list):
Generic drugs: Drugs that contain
the same active ingredients as
their brand-name counterpart, but
are generally less expensive.
Thrifty White Pharmacy: (888) 558-9941
Fairview Specialty Pharmacy: (612) 672-5288 or (877) 509-5114
Specialty drugs: Drugs typically
used to treat certain complex
diseases. Specialty medications
tend to be very expensive and
may require special handling or
monitoring.
Your specialty drug benefit depends on the specialty drug tier and where you fill
your prescription. Remember, you’ll pay less for prescription drugs when you fill
your prescriptions at a Thrifty White pharmacy. To view your plan’s pharmacy
benefits, log in to mymedica.com and choose Benefits & Coverage > Summary
of Benefits & Coverage.
Benefit Level 1*
Thrifty White Pharmacy
Limited Distribution Pharmacy
Benefit Level 2
Fairview Specialty Pharmacy
Tier 1
Specialty Drug
Includes:
Preferred Specialty Drug filled at a Thrifty White
Pharmacy
Preferred Specialty Drug filled at a Limited
Distribution Pharmacy (that cannot be filled
at a Thrifty White Pharmacy).
Includes:
Preferred Specialty Drug that could be filled at a
Thrifty White Pharmacy but is filled at Fairview
Specialty Pharmacy.
Tier 2
Specialty Drug
Includes:
Non-preferred Specialty Drug filled at a
Thrifty White Pharmacy
Non-preferred Specialty Drug filled at a Limited
Distribution Pharmacy (that cannot
be filled at a Thrifty White Pharmacy).
Includes:
Non-preferred Specialty Drug that could be filled
at a Thrifty White Pharmacy but is filled at Fairview
Specialty Pharmacy.
*Includes Fairview Specialty Pharmacy if specific drug is not available at Thrifty White Pharmacy.
GETTING PRESCRIPTIONS FILLED
You’ll pay less for prescription drugs when you fill your prescriptions at a Thrifty White pharmacy. Medica’s pharmacy network
also includes more than 60,000 pharmacies nationwide. Log in to mymedica.com to find one near you.
Your plan offers additional ways to get your prescriptions filled:
90-Day Refill Option – The Thrifty White 90-day refill option allows you to pick up a
three-month supply of medication at one time from a Thrifty White Pharmacy or
other Medica Choice90RX pharmacy for the price of a two-month supply. Ask your doctor
to write a prescription with refills for up to a 90-day supply of your medication.
Thrifty White Mail Order – The Thrifty White mail order pharmacy program allows
you to have ongoing medications mailed to your home. Call the Thrifty White
Patient Care Center at 1-888-558-9941 to enroll.
© 2014 Medica. Medica® is a registered service mark of Medica Health Plans. “Medica” refers to the
family of health plan businesses that includes Medica Health Plans, Medica Health Plans of Wisconsin,
Medica Insurance Company, Medica Self-Insured, and Medica Health Management, LLC.
COM9729-1-01014 Thrifty White Stores
TIP: Remember to show your
Medica ID card when filling
prescriptions. If you misplace
your card, you can print a
temporary one and order a
replacement on mymedica.com.