CIGNA Managed Pharmacy Program

Pharmacy Alternatives for the Way You Live Today

It's important to be an informed consumer, especially when it comes to prescription drugs. Know the options — ask questions, learn about and request treatment alternatives, better manage health conditions and save money, too. Our prescription drug plans offer access to more than 57,000 national and independentparticipating pharmacies to get your prescriptions filled. Members also order your prescriptions online with CIGNA Tel-Drug for convenient home delivery.

With a Pharmacy plan through CIGNA HealthCare, we help keep members informed on what is covered, what is not and why. Members have access to important information including:

• A breakdown of plan coverage and payment options
• Costs associated with your plan
• Alternatives for brand medications and the benefits of generics
• A list of covered prescription drugs under your plan
• A directory of participating pharmacies

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Understanding Your Plan —Not a Bitter Pill

The easiest way to know which prescription drug plan you have is to check your CIGNA HealthCare ID card or your enrollment materials for the copayment or coinsurance amounts shown for prescriptions:

• 1-tier benefit: There are two kinds of prescription drug lists under the single-tier plan: OPEN means generic and brand prescription medications are covered, with the exception of any medications specifically excluded by the plan. CLOSED means only those generic and brand medications listed on the prescription drug list are covered.
• 2-tier benefit: medications are divided into two categories, or tiers: GENERIC (first tier) and BRAND (second tier). There are two kinds of prescription drug lists under the two-tier plan: OPEN means all generic medications are covered under the generic coverage level, and all brand medications are covered under the brand coverage level. CLOSED means only those generic and brand medications listed on the prescription drug list are covered.
• 3-tier benefit plans have separate copays or coinsurance for:
• Generic drugs
• Preferred Brand drugs
• Non-Preferred Brand drugs

4-tier therapeutic benefit plans have separate copays or coinsurance for:

• Generic drugs
• Preferred Brand drugs
• Non-Preferred Brand drugs
• Theraputic drugs (self-administered injectables, antihistamines, oral contraceptives, cold, cough and expectorants, or erectile dysfunction

4-tier-by-cost benefit benefit plans have separate copays or coinsurance for:

• Generic drugs
• Preferred Brand drugs where average cost is less than $100
• Preferred Brand drugs where average cost is greater than $100
• Non-Preferred Brand drugs

Learn more about how to use your prescription drug plan. If you're not yet a CIGNA HealthCare member, your enrollment materials will indicate which prescription drug plan is offered to you.

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Trouble-Free Payment Option Analysis

When you receive a prescription, the amount you'll pay at the pharmacy depends on 3 things:

1) Whether your prescription is covered in your plan's prescription drug list.

2) The category (or tier) in which your prescription medication is listed.

3) Whether a medication or dose requiring prior authorization for coverage under your prescription drug plan has been approved.

With most plans, you're required to share in the cost of your prescriptions by paying a copayment or coinsurance, and/or by satisfying a deductible.

• A copayment is a predetermined amount, that you pay when you have a prescription filled. You can find your copayment amount(s) on your CIGNA HealthCare ID card.
• Coinsurance is a percentage of the covered charges that you pay for your prescriptions. For example, your plan may pay 80% of the discounted retail drug cost and you pay the remaining 20%.
• A deductible is a fixed dollar amount that you pay out-of-pocket each year for covered prescription drugs before your prescription drug plan will pay any benefits. You'll need to meet the deductible before your prescription drug plan copayments or coinsurance apply.

Please check your plan materials, myCIGNA, or your CIGNA HealthCare ID card to see copayment, coinsurance and/or deductible amounts that you'll have to pay for your prescriptions. On myCIGNA.com, use our Prescription Drug Price Quotes Tool to see what your prescription will cost at a retail pharmacy and to identify your cost savings through CIGNA Tel-Drug Home Delivery.

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Special Programs

Employer Advantages

CIGNA HealthCare's Medical and Pharmacy teams have joined together to provide integrated data, benefits administration and case management programs. These programs identify members with serious conditions who present opportunities for improved care. Each of these programs is designed to keep members healthier and reduce additional medical costs. The programs currently in place are:

• Asthma Outcome Improvement Program
• Cholesterol Outcome Improvement Program
• Depression Outcome Improvement Program
• Diabetes Outcome Improvement Program

Your employees have access to:

• Licensed pharmacists on call 24 hours a day
• Place new and refill orders, track order status and prescription order history at myCIGNA.com
• 24-hour internet and telephone access for ordering prescription refills
• Quality-conscious program with exceptionally high standards of customer service
• Enhanced member convenience and satisfaction through the program's focus on maintenance drugs and prompt home delivery
• Convenient ordering options by phone, Internet or mail

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FAQ

• What is the prescription drug list?
• How can I find out if a drug is on the prescription drug list?
• Does my doctor know what's on the prescription drug list?
• How does CIGNA HealthCare keep the prescription drug list up-to-date?
• What can I do if my prescription is not on the prescription drug list?
• What is a generic drug?
• Are generic drugs as safe as the brand-name drugs?
• Are there differences between a brand-name drug and its generic version?
• Do generic drugs take longer to work?
• Are generics available for all brand-name drugs?
• Why should I use a generic drug?
• How do I get a generic drug?

What is the prescription drug list?
It is an extensive list of brand-name and generic prescription drugs that are covered by CIGNA HealthCare. The CIGNA HealthCare prescription drug list is developed and updated on a regular basis in accordance with clinical recommendations of the CIGNA HealthCare Pharmacy and Therapeutics Committee, a panel of participating physicians and pharmacists. Only those medications that have been approved by the FDA are included in the list.

How can I find out if a drug is on the prescription drug list?
If you have questions about the CIGNA HealthCare prescription drug list or want to know whether a drug is on the list, go to the prescription drug list or call Member Services at the number on your CIGNA HealthCare ID card.

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Does my doctor know what's on the prescription drug list?
Doctors in the network have copies of the prescription drug list and should refer to the list when they need to prescribe drugs to CIGNA HealthCare members.

How does CIGNA HealthCare keep the prescription drug list up-to-date?
The CIGNA HealthCare Pharmacy and Therapeutics (P&T) Committee, a panel of independent physicians and pharmacists, updates this list regularly. The list includes quality drugs available to you at reasonable cost. The P&T Committee reviews and evaluates all available literature on a drug when updating the list.

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What can I do if my prescription is not on the prescription drug list?
If your doctor prescribes a medication that is not on the prescription drug list, you can:

• Pay the retail cost of the prescription.
• Ask your doctor to request prior authorization from CIGNA
• Discuss drug or other treatment alternatives with your doctor.

What is a generic drug?
A generic drug is a medication whose active ingredients, safety, dosage, quality and strength are identical to that of its brand-name counterpart.

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When a new medication becomes available, it is sold under a brand name chosen by its manufacturer and protected by a patent. After the drug's patent protection expires, other manufacturers can begin offering additional medications with the same active ingredients as the brand-name drug. These drugs, called generic drugs, are usually less expensive than their brand-name counterparts.

Are generic drugs as safe as the brand-name drugs?
Yes. The FDA has a single quality standard for all drugs, both brand-name and generic. Before a generic drug is available for sale, the manufacturer of the generic drug must prove to the FDA that the generic version is as safe as the brand-name drug.

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Are there differences between a brand-name drug and its generic alternative?
Yes. Although the active ingredients are identical, you may notice differences in such things as shape, packaging, fillers (such as colors and flavors), expiration time and, within certain limits, package labeling. To ensure generic drugs are just as effective and safe as their brand-name versions, the federal Food and Drug Administration (FDA) requires that all drugs, both brand-name and generic drugs, meet the same requirements for quality, strength, purity and potency.

Do generic drugs take longer to work?
No. When a manufacturer wants to market a generic version of a drug, it must provide evidence to the FDA that the generic drug works in the body just like the brand-name drug, and within the same amount of time as the brand-name drug.

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Are generic drugs available for all brand-name drugs?
No. Manufacturers can only produce generic drugs after the brand-name version of the drug loses its patent protection. Even after a patent expires, manufacturers may choose not to make a generic version of a particular drug. Today, about half of all brand-name drugs have generic counterparts.

Why should I use a generic drug?
Generic drugs can provide real value. Generic drugs usually cost from 30-75 percent less than their brand-name counterparts, and, since the FDA is very strict about approving generic drugs, you can be assured that the generic drug you receive is a safe and effective alternative to the brand-name drug.

How do I get a generic drug?
Ask your pharmacist or doctor to better understand the generic choices available to you. Your physician will likely prescribe a generic drug or will refer to a drug by the brand-name. If the brand-name drug has a generic equivalent, in most cases your pharmacist can switch your prescription to the generic drug when you have it filled. Your pharmacist will tell you if your doctor should be consulted before changing to a generic drug.

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