Health & Wellness

Prescription drug coverage

Both health system medical plans include prescription medication coverage.

Refer to the Pharmacy Resource Guide for more details on how costs work for prescriptions in each medical plan, the pharmacies you can use, what’s new for 2025 and how to save money.

How medication costs work in each medical plan

HSA Advantage Plan	Signature Plan
Uses primarily coinsurance: You pay 100% of the cost until your deductible is met, then a percentage until you reach your out-of-pocket maximum.	Uses primarily set copay amounts, regardless of whether your deductible has been met.
The coinsurance percentage is the same for all medication cost tiers, but a drug in a higher-cost tier means you’ll likely pay more out-of-pocket.	The higher the medication tier, the higher the copay.
Your coinsurance and the price of most medications, is lowest with the health system pharmacy.	Copays are lowest with the health system pharmacy.
If you use a pharmacy that is out-of-network: Pay 50% coinsurance after you meet your separate out-of-network deductible.	If you use a pharmacy that is out-of-network: Pay 50% coinsurance after you meet your separate out-of-network deductible.

Medication costs under the HSA Advantage Plan

For all medications (except those on the preventive drug list), you pay the full cost until you reach your annual deductible. After that, you pay coinsurance:

10% with health system pharmacy
30% at in-network pharmacy (for acute medications only – all others must be filled by the health system pharmacy)

Medication costs under the Signature Plan

Acute medications

(treat short-term symptoms for a specified period of time)

Fill with health system pharmacy, Medical Park Pharmacy in Great Bend (at health system rate) or an in-network pharmacy (higher cost).

	Health system pharmacy		In-network pharmacy*
Cost tier	Up to 34 day supply	35-102 day supply	Up to 34 day supply	35-102 day supply
Tier 1 $	$5.00	$10.00	$25.00	$50.00
Tier 2 $$	$30.00	$60.00	$55.00	$110.00
Tier 3 $$$	$65.00	$130.00	$90.00	$180.00
Tier 4 $$$$	N/A	N/A	N/A	N/A
* Visit KansasHealthSystemBenefits.com/NetworkRx for list of in-network pharmacies.

Maintenance medications

(prescribed for long-term, regular use to treat chronic health conditions)

Must fill with health system pharmacy for at least 90 days as permitted and use free delivery.

	Health system pharmacy		In-network pharmacy
Cost tier	Up to 34 day supply	35-102 day supply	Up to 34 day supply	35-102 day supply
Tier 1 $	$5.00	$10.00	Only covered when filled by health system pharmacy.
Tier 2 $$	$30.00	$60.00
Tier 3 $$$	$65.00	$130.00
Tier 4 $$$$	$100.00	$200.00

Specialty medications

(treat chronic, complex health conditions)

Must fill with health system pharmacy.

	Health system pharmacy		In-network pharmacy
Cost tier	Up to 30 day supply	35-102 day supply	Up to 34 day supply	35-102 day supply
Tier 1 $	$20.00	Specialty medications may only be filled for 30 days or less.	Only covered when filled by health system pharmacy.
Tier 2 $$	$100.00
Tier 3 $$$	$200.00
Tier 4 $$$$	N/A

Savings for chronic conditions

Many maintenance medications used to treat or reduce the risk of chronic conditions (such as insulin) are on the preventive drug list: KansasHealthSystemBenefits.com/PreventRx/.

HSA Advantage Plan members pay the Signature Plan copay, typically far lower than deductible plus coinsurance. These copays do not apply to the HSA Advantage Plan deductible but do apply to the out-of-pocket maximum.