Click here to see information about 2025 benefits
Click here to see information about 2025 benefits
Both medical plans – the HSA Advantage Plan and Signature Plan – include prescription medication coverage.
Refer to the Pharmacy Resource Guide now and year-round for details on how costs work for prescriptions in each medical plan, the pharmacies you can use and how to save money.
HSA Advantage Plan | Signature Plan |
Primarily users coinsurance: You pay 100% of the cost until your deductible is met, then a percentage until you reach your out-of-pocket maximum. | Primarily uses set copay amounts, regardless of whether your deductible has been met. |
The coinsurance percentage is the same for all tiers of medications; however, a drug in a higher-cost tier, such as tier 4, 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, you pay 50% coinsurance after you meet your separate out-of-network deductible. | If you use a pharmacy that is out-of-network, you pay 50% coinsurance. |
Prescriptions fall under three general medication types — acute, maintenance and specialty — that determine where you can fill the prescription and how many days’ supply you can receive. For the best service and lowest cost, use the health system pharmacy.
Medication Type | What they are | Where to fill |
Treat short-term symptoms for a specified period of time (antibiotics, antivirals, steroids, etc.) |
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Treat long-term, chronic conditions (asthma, diabetes, high blood pressure, etc.) |
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Treat complex, chronic health conditions (Crohn’s disease, cancer, cystic fibrosis, etc.) |
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Many maintenance medications used to treat or reduce the risk of chronic conditions (such as insulin) are on the preventive drug list: KansasHealthSystemBenefits.com/PreventiveRx.
HSA Advantage Plan members pay the Signature Plan copay, which is typically far lower than deductible plus coinsurance, offering savings. These copays do not apply to the HSA Advantage Plan deductible but do apply to the out-of-pocket maximum.
The chart below shows differences in prescription coverage between the two medical plans.
HSA Advantage Plan^ | Signature Plan | |||||
Health system Pharmacy* | In-network pharmacy** | In-network pharmacy** | ||||
Acute prescriptions | Up to 102-day supply | Up to 102-day supply | Up to 34-day supply | 35- to 102-day supply | Up to 34-day supply | 35- to 102-day supply |
Tier 1 $ | Deductible + 10% coinsurance | Deductible + 30% coinsurance | $5 | $10 | $25 | $50 |
Tier 2 $$ | $30 | $60 | $55 | $110 | ||
Tier 3 $$$ | $65 | $130 | $90 | $180 | ||
Maintenance prescriptions | Up to 102-day supply | Up to 102-day supply | Up to 34-day supply | 35- to 102-day supply | Up to 34-day supply | 35- to 102-day supply |
Tier 1 $ | Deductible + 10% coinsurance | Only covered when filled by health system pharmacy. | $5 | $10 | Only covered when filled by health system pharmacy. | |
Tier 2 $$ | $30 | $60 | ||||
Tier 3 $$$ | $65 | $130 | ||||
Tier 4 $$$$ | $100 | $200 | ||||
Specialty prescriptions | Up to 30-day supply | Up to 30-day supply | Up to 30-day supply | Up to 30-day supply | Up to 30-day supply | Up to 30-day supply |
Tier 1 $ | Deductible + 10% coinsurance | Health system pharmacy is exclusive provider. | $20 | Specialty medications may only be filled for 30 days or less. | Health system pharmacy is exclusive provider. | |
Tier 2 $$ | $100 | |||||
Tier 3 $$$ | $200 | |||||
^HSA Advantage Plan members will pay 100% until their deductible is met, then pay the indicated percentage coinsurance until their out-of-pocket maximum is reached.
*Certain medications used for chronic conditions or risk reduction are included in the preventive drug list. HSA Advantage Plan members will pay Signature Plan copays for medications on the list. These copays will not apply to the HSA Advantage Plan deductible but will apply to the out-of-pocket maximum.
**While the health system pharmacy should be your first choice for prescriptions, many pharmacies throughout the nation participate in the pharmacy network.