Prescription Drug Program

All information presented on this page, including links to plan documents and descriptions, is specific to the plan year of July 1, 2023 - June 30, 2024.

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.

Members may obtain a 90-day supply of medications at any participating retail pharmacy. Three co-payments will apply, while only two co-payments are required when you obtain medications by mail order, at the Falk Clinic Pharmacy, or at the University 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:
    • Phone refills
    • Online refills
    • Free office delivery (Locations and Delivery Times)
    • 90-day prescriptions, for only two co-payments
    • Employee discounts on over-the-counter medications
  • 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

Visit the UPMC Pharmacy Services website to:

  • 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

Comprehensive Medication Management

As part of your UPMC Health Plan wellness benefits, the University's Benefits Department now offers Comprehensive Medication Management services. Sit down with a pharmacist to answer all of your medication-related questions and develop an action plan to take better control of your health. This service is offered at no-cost to all full-time and part-time regular University faculty and staff with UPMC Health Plan coverage. Learn more about the Comprehensive Medication Management program.

 

Please visit the Glossary of Terms page for commonly used medical terms and definitions.