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Pharmacy Benefit and Formulary Information

Announcing WellTrak

HIRSP is excited to introduce WellTrak, a no cost program to help HIRSP members manage their prescription and over-the-counter medictions.  WellTrak is designed to help you manage your medications by giving you confidential access to speak one-on-one with a WellTrak clinical pharmacist.  The WellTrak pharmacist will work with you and your primary care providers to ensure you are experiencing the best results from your medications. For more information on the WellTrak program, please click here.

Pharmacy Benefits

HIRSP members have access to high quality prescription drug benefits at a reasonable cost. In this area you will find information about the drug formulary, which is a list of covered or reimbursable drugs approved for use by HIRSP members. You can also find information on how to receive Prior Authorization for certain prescriptions, as well as drug claim forms.

Most specialty medications as defined in your HIRSP policy require Prior Authorization.

HIRSP members are required to pay a $5, $55 or $75 co-payment depending on the prescription drug they are purchasing. $5 copayments are required for most generic drugs. $55 copayments are required for brand drugs, some high-cost generic drugs and generic specialty drugs. $75 copayments are required for specialty brand drugs.

HIRSP Federal members are required to pay a $5 or $45 co-payment depending on the prescription drug they are purchasing. $5 copayments are required for most generic drugs. $45 copayments are required for brand drugs and some high-cost generic drugs.

HIRSP Medicare Supplement members must use their Medicare Part-D formulary and NOT HIRSP formulary when purchasing medications. HIRSP Medicare Supplement members will follow the same copay structure as stated above. Therefore, most generics drugs on the member's Part-D formulary will be charged a $5 co-payment. Brand drugs, some high-cost generic drugs and generic specialty drugs on the member's Part-D formulary will be charged a $55 co-payment. Specialty brand drugs on the member's Part-D formulary will be charged a $75 co-payment.

HIRSP Dedicated Pharmacy Unit

1-800-757-5576
Monday through Friday 8:00 a.m. - 9:00 p.m. CST
Saturday 9:00 a.m. - 6:00 p.m. CST

Drug recalls and notices

• Actavis Totowa LLC has issued a recall of all Digitek® (digoxin) tablets for oral use
• Duragesic, sold by PriCara, voluntarily recalled
  

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