Special Prescription Drug Programs

U-M prescription drug plan members may receive notification about participating in a voluntary prescription drug program.

MHealthy Tobacco Consultation Service and Affordable Care Act - $0 Copay for Tobacco Cessation

Prescription only and generic over-the-counter (OTC) smoking cessation medications are covered at zero ($0) copay for eligible members of the U-M prescription drug plan. This coverage complies with the preventive care services provisions required under the Affordable Care Act. To receive the zero ($0) copay benefit, members need either a doctor's prescription or an MHealthy Tobacco Consultation Service (TCS) authorization letter prescribing the smoking cessation medication. Products include generic nicotine patches, generic nicotine gums, and generic nicotine lozenges. Brand name OTC nicotine replacement products will not be covered. Patients interested in prescription quit aids such as Chantix will need a prescription from their physician.  Further detail is available in the letter from Magellan Rx.

Please note that participation with TCS is not required to obtain smoking cessation medications at $0 copay under the U-M drug plan. However, behavioral support can provide important help to quit tobacco. For behavioral support, employees (and their spouses or OQAs) can choose from a variety of program options including individual, internet-based or telephonic tobacco treatment sessions through TCS. 

Sponsors

Phone

  • (888) 272-1346 Magellan Rx Member Service
  • (734) 998-6222 MHealthy Tobacco Consultation Service

Vaccines Covered in Pharmacies and Doctor’s Offices 

As of January 1, 2020, U-M’s benefit plans cover approved vaccinations under both your pharmacy through the U-M Prescription Drug Plan and through your U-M health plan.

Approved vaccines require no co-pay on your part. Coverage is a prevention benefit in all U-M health plans.

Previously, vaccine coverage was only available through the health plans. U-M expanded vaccine coverage to members’ U-M Prescription Drug Plan to help pharmacy partners streamline the payment process.

When receiving your shot at a pharmacy, provide your vaccine prescription, and either your medical or drug plan ID card. Don’t use both cards or there could be confusion.

The following pharmacy-administered vaccines are covered:

  • Influenza

  • Hepatitis A and B

  • HPV

  • Measles, mumps and rubella

  • Meningococcal

  • Polio

  • Pneumococcal

  • Shingles

  • Tetanus, diphtheria and whooping cough

  • Varicella

Some of these immunizations require more than one dose to be most effective. Coverage also can be limited because of age and time of vaccination. View these guidelines from the Centers for Disease Control and Prevention before getting an immunization.