Understanding medication categories: acute, maintenance and specialty
Understanding how your medications are classified is the easiest way to get the right drug at the best price. Where you fill your prescription and the quantity or dosage you can receive depends on the type of medication you are prescribed.
The category of medication and where you fill it
Prescriptions fall under three general medication types — acute, maintenance and specialty — that determine which pharmacy you can use and how many days of medicine you can get at one time.
Medication category | 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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Acute medications
Drugs that treat short-term symptoms for a specific period of time (antibiotics, antivirals, steroids, etc.)
Use any health system or in-network pharmacy
Acute medications treat short-term symptoms such as those for a sinus infection or flu. You can fill them at the health system pharmacy or any in-network pharmacy.
What acute medications cost
HSA Advantage Plan members:
- You pay the full cost until you reach your annual deductible. After that, you pay coinsurance based on where you fill the prescription.
- Using a medication in a lower-cost tier on the formulary means less out-of-pocket cost for you.
Health system pharmacy | In-network pharmacy | |
Acute prescriptions | Up to 3 months | Up to 3 months |
Tier 1 $ | Deductible + 10% coinsurance | Deductible + 30% coinsurance |
Tier 2 $$ | ||
Tier 3 $$$ |
Signature Plan members:
You pay a fixed copay (flat fee) based on the drug’s tier, as listed in the prescription drug formulary. The amount of the copay will also vary based on whether you use the health system pharmacy or an in-network pharmacy.
Health system pharmacy | In-network pharmacy | |||
Acute prescriptions | One month | Up to 3 months | One month | Up to 3 months |
Tier 1 $ | $5 | $10 | $25 | $50 |
Tier 2 $$ | $30 | $60 | $55 | $110 |
Tier 3 $$$ | $65 | $130 | $90 | $180 |
How to fill your acute medication prescriptions
The University of Kansas Health System Bell Hospital Tower Retail Pharmacy* | The University of Kansas Health System Indian Creek Retail Pharmacy* | The University of Kansas Health System Cambridge Retail Pharmacy | The University of Kansas Health System Westwood Retail Pharmacy |
4000 Cambridge St. Kansas City, KS 66160 | 10710 Nall Ave. Overland Park, KS 66211 | 3825 Cambridge St. Kansas City, KS 66160 | 2650 Shawnee Mission Pkwy. Westwood, KS 66205 |
913-588-2361 | 913-574-4805 | 913-574-3100 | 913-945-7700 |
*Note: Bell Hospital Tower Retail Pharmacy is shown in provider electronic systems as “Bell Hospital TUKHS Retail Pharmacy.” Indian Creek Retail Pharmacy is shown in provider electronic systems as “Indian Creek TUKHS Retail Pharmacy.” | |||
Maintenance medications
Drugs that are often taken daily to manage chronic health conditions
Always use the health system pharmacy with free delivery
The vast majority of prescriptions covered under our health plan are maintenance medications, generating thousands of fills every month. Because of the high volume, they must be filled and delivered by the health system pharmacy (Southlake location).
What maintenance medications are used for
The following health conditions are typically treated with maintenance medications. Visit the formulary for a list of covered medications. Not every drug that treats these conditions is included in the formulary. To be certain about coverage for your specific prescription, call Judi Rx at 833-599-0951.
ADHD management | Endocrine conditions | Parkinson’s disease |
Birth control | Eye conditions | Preventing migraines |
Bladder & urinary health | Gout relief | Reducing fluid buildup |
Blood & clotting disorders | Heart rhythm & chest pain | Seizure prevention |
Blood clot prevention | Hormone balance | Skin conditions |
Blood-forming disorders | Kidney health | Stomach conditions |
Blood pressure | Immune suppression | Sleep & relaxation |
Cancer treatment | Lung & airway conditions | Strengthening teeth |
Cholesterol levels | Malaria treatment | Thyroid health |
Cognitive function | Metabolic conditions | Viral infection treatment |
Depression | Mood & thought disorders | Vitamins & minerals |
Diabetes | Nerve & muscle function | Wakefulness support |
Dry mouth | Neurological disorders | Weight management |
Electrolyte supplements | Pain relief & inflammation |
What maintenance medications cost
HSA Advantage Plan members:
- Some maintenance medications are included on the preventive drug list. If your drug is on this list, you pay the same copay as the Signature Plan (see chart below), which is typically lower than the deductible plus coinsurance.
- For all other medications, you pay the full cost until you reach your deductible. After that, you pay 10% coinsurance with the health system pharmacy.
- Using a medication in a lower-cost tier on the formulary means less out-of-pocket cost for you.
Health system pharmacy | In-network pharmacy | |
Maintenance prescriptions | Up to 3 months | Up to 3 months |
Tier 1 $ | Deductible + 10% coinsurance | Only covered when filled by health system pharmacy |
Tier 2 $$ | ||
Tier 3 $$$ | ||
Tier 4 $$$$ |
Signature Plan members:
- You pay a set copay based on the medication tier, as listed in the formulary
Health system pharmacy | In-network pharmacy | |||
Cost tier | One month | Up to 3 months | One month | Up to 3 months |
Tier 1 $ | $5 | $10 | Only covered when filled | |
Tier 2 $$ | $30 | $60 | ||
Tier 3 $$$ | $65 | $130 | ||
Tier 4 $$$$ | $100 | $200 | ||
How to fill new maintenance prescriptions at the health system pharmacy
- Review the maintenance drug list to see if your drug is a maintenance medication.
- If it is, ask your provider to send a new electronic prescription for a 3-month supply to the Southlake location – this is our central hub for home deliveries:
The University of Kansas Health System Southlake Retail Pharmacy
11300 Corporate Ave., Lenexa, KS 66219
913-574-0600
Specialty medications
Drugs that treat complex, chronic health conditions (for example Crohn’s disease, cancer, cystic fibrosis, etc.)
Use the health system pharmacy
Specialty medications must be filled by the health system pharmacy unless otherwise noted by the formulary. Because of the high volume, they must be filled and delivered by the health system pharmacy (Southlake location).
What specialty medications cost
HSA Advantage Plan members:
- You pay the full cost until you meet your deductible. After that, you pay 10% coinsurance with the health system pharmacy.
- Using a medication in a lower-cost tier on the formulary means less out-of-pocket cost for you.
- Copay cards or manufacturer assistance coupons can be used to help lower your out-of-pocket cost for specialty and high-cost brand medications. The amount paid by the manufacturer will not apply to your deductible or out-of-pocket maximum.
Health system pharmacy | In-network pharmacy | |
Speciality prescriptions | Up to one month | Up to one month |
Tier 1 $ | Deductible + 10% coinsurance | Only covered when filled by health system pharmacy |
Tier 2 $$ | ||
Tier 3 $$$ |
Signature Plan members:
- You pay a set copay based on the drug’s tier, as listed in the prescription drug formulary.
Health system pharmacy | In-network pharmacy | |||
Specialty prescriptions | One month | One month | ||
Tier 1 $ | $20 | Specialty medications may only be filled for one month or less. | Only covered when filled by the health system pharmacy | |
Tier 2 $$ | $100 | |||
Tier 3 $$$ | $200 | |||