Prescription Drug Program

University of Pittsburgh medical plans include comprehensive prescription drug coverage. Features of the prescription drug program include:

Prescription Drug Rider

The Prescription Drug Rider establishes the terms of coverage, member responsibilities, and policies and procedures to be followed in order for prescription drugs to be covered under your benefit plan.

Please note that the prescription drug formulary is subject to change periodically based upon decisions by the UPMC Pharmacy and Therapeutics Committee. Examples include the introduction of new medications and changes in tier level (i.e., from brand name to generic).

Members may obtain a 90-day supply of medications at any participating retail pharmacy. However, three co-payments will apply, unlike when you obtain medications by mail order or at the Falk Clinic Pharmacy. For example, at the University Pharmacy, members pay $32 for a 90-day supply of generic medication, while the cost is $48 at a retail pharmacy.

Prescription Co-Payment Savings

  • Express Scripts mail-order services—Long-term maintenance medications may be obtained through the Express Scripts mail-order pharmacy. The University's prescription drug program allows you to receive 90-day supplies for most prescriptions while paying only two co-payments.
  • Falk Clinic Pharmacy—Falk Pharmacy, the flagship pharmacy of UPMC, offers a variety of services, including:
  • University Pharmacy -The on-campus University Pharmacy provides first-class pharmacy services to Pitt faculty, staff, and students. Services include:
    • Full prescription services
    • Over-the-counter medications
    • Unlimited patient counseling
    • 90-day prescriptions, for only two co-payments

UPMC Pharmacy Services

Through the UPMC Pharmacy Services Web site, you may:

  • Search to see if a particular drug is covered
  • Locate a pharmacy
  • Learn how to enroll in mail-order prescriptions
  • Download a Prescription Drug Claim Reimbursement form