Prescription Drug Plan - EpiphanyRx
If you enroll in the City of Chattanooga medical plans, you automatically receive prescription drug coverage administered by EpiphanyRx. EpiphanyRx has been the City's PBM partner since July 2022. You will get a separate ID card from EpiphanyRx. Please ensure your pharmacist is filling prescription claims through EpiphanyRx and not BlueCross.
If you enroll in the PPO plan, your plan features copays for prescription drugs. You have three choices of where to purchase prescriptions: the WellAdvantage pharmacy, retail pharmacies or through home delivery. Your copays are listed in the table below.
*If you enroll in the HDHP plan with HSA, then all your pharmacy charges will apply towards your deductible. Then, you will pay 20% of the cost of the prescription (the plan pays 80%) until you meet your out-of-pocket maximum amount.
Copay Assistance
Manufacturer copay assistance programs help insured patients afford expensive (brand and specialty)prescription drugs. You must enroll in the program before your first fill to take advantage of the savings. The EpiphanyRx member services team can help you enroll to take advantage of the savings. Only the amount you paid for the drug can be applied toward your deductible and/or out of pocket maximum. Some programs require annual re-enrollment.
Specialty Medications
If you take a specialty medication, a member of the EpiphanyRx team will be reaching out to you to help you transfer your prescription to the new specialty pharmacy, Lumicera.
Mail Order Pharmacy - Costco
If you take a maintenance medication and would like to utilize mail order, register with Costco Home Delivery. Costco offers convenient delivery options and makes refilling your medications easy with the ability to refill by phone, online and text.
To get started, go to pharmacy.costco.com and click "Get Started."
Contact Information:
EpiphanyRx Member Services
1-844-820-3260
Lumicera Specialty Pharmacy
1-855-847-3553
Costco Mail Order Pharmacy
1-800-607-6861
EpiphanyRx Plan Reference Guide - PPO
EpiphanyRx Plan Reference Guide - HDHP
OTC Medications
Because of the rising cost of prescription drugs and because so many frequently prescribed medications are available over-the-counter (OTC), your pharmacy benefit plan does not cover prescription drugs that have an OTC alternative. This may help you to buy the medications you need, when you need them without having to get a prescription from your physician. Contact EpiphanyRx member services for additional information.
Over the Counter Alternatives
While there are several classes of medications available OTC, some of the most popular are widely prescribed classes are:
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Allergy treatment drugs, such as non-sedating anti-histamines (known as NSAs)
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Stomach disorder drugs, such as HS blockers and proton pump inhibitors (known as H2s + PPIs)
Talk with your doctor to see which OTC products might work for you. You can continue to take prescription products if you choose, but you will be responsible for paying the full cost of the drug.
If your doctor has a medical reason for you to take a PPI prescription medication rather than an OTC alternative, prior authorization may be required.