Prescription Drug Coverage
If you’re enrolled in the Tufts Student Health Insurance Plan (SHIP), you have prescription drug coverage through UnitedHealthcare StudentResources (UHCSR).
Most common medications are covered, but it’s important to check ahead of time to avoid unexpected costs. You can fill prescriptions at most major retail chains and local pharmacies across the U.S., as long as they’re in-network with UHCSR. Using an in-network pharmacy helps you save money and ensures your prescription is covered.
For a full overview of your SHIP benefits, visit What SHIP Covers.
Check If Your Medication Is Covered
Before filling a prescription, check if your medication is on the UHCSR formulary to avoid unexpected costs. Visit uhcsr.com/tufts and select Prescription Drug List or Rx Formulary, or call UHCSR at 1-855-828-7716.
What You’ll Pay
Your cost depends on the type of medication (Tier 1, 2, or 3), the length of your supply (30, 60, or 90 days), and whether you use an in-network or out-of-network pharmacy.
Medication Tiers
- Tier 1: Generic — lowest cost
- Tier 2: Preferred brand-name — moderate cost
- Tier 3: Non-preferred brand-name — highest cost
In-Network Pharmacies
Supply Length | Tier 1 | Tier 2 | Tier 3 |
|---|---|---|---|
30-day | $25 | $50 | $75 |
60-day | $50 | $100 | $150 |
90-day | $75 | $150 | $225 |
Using an in-network pharmacy is strongly recommended for the lowest cost.
Out-of-Network Pharmacies
If you use a pharmacy outside the UHCSR network, you may pay significantly more: a $20 copay for generic drugs, a $45 copay for brand-name drugs, or 20% coinsurance, whichever is greater.
90-Day Mail Order
If you take medication regularly, switching to a 90-day supply through OptumRx (the plan’s mail-order pharmacy) can save you time and reduce trips to the pharmacy.
How to Order
- Ask Your Doctor to send a 90-day prescription to OptumRx via ePrescribe (preferred), by fax at 800-491-7997, by phone at 800-791-7658, or by mail (forms at OptumRx.com).
- Set Up Your Account: Call 1-800-562-6223 with your name, date of birth, shipping address, doctor’s contact information, and payment information.
- Receive Your Medication: Once processed, your medication is shipped directly to you.
Mail-Order Costs
Tier | 90-Day Supply |
|---|---|
Tier 1 | $62.50 |
Tier 2 | $125 |
Tier 3 | $187.50 |
Tip: Use in-network pharmacies and mail order whenever possible to save money.
Specialty Medications & Designated Pharmacies
If your doctor prescribes a medication that requires special handling — such as injections, cold storage, or ongoing monitoring — you may need to use a specialty pharmacy. Specialty pharmacies offer home delivery, refill coordination, and 24/7 pharmacist access. These prescriptions must be filled at a Preferred Specialty Network Pharmacy.
Designated Pharmacies
Some medications require you to use a specific designated pharmacy for full coverage benefits. If you choose not to, you must opt out or you’ll pay the full cost. To opt out, visit uhcsr.com/tufts or call UHCSR: 1-855-828-7716.
Early Refill for Travel
If you’re traveling and your refill isn’t due yet, you can request a vacation override to fill your prescription early. Note that overrides can’t extend past August 19 (end of plan year) and that not all medications qualify. Remember to submit at least one week before travel.
- How to Request: You can ask your pharmacy to request the override, or email: pbm@uhcsr.com.
- Include In Your Email:
- Subject: Vacation Override – Tufts University
- Your full name, date of birth, UHCSR ID
- Prescription name(s) and quantity
- Paid travel itinerary
- Your phone number & pharmacy phone number
Requesting Reimbursement
If you paid out of pocket for a covered prescription:
- Complete the Prescription Reimbursement Request Form in your UHCSR account
- Attach your pharmacy receipt
- Submit to UHCSR
Questions
For questions about prescriptions:
- UHCSR Customer Service: 1-855-828-7716
- Use the Pharmacy Locator at uhcsr.com/tufts
- Prescription Drug List or Rx Formulary
- Tufts Student Health Insurance Office: studenthealthinsurance@tufts.edu
- OptumRx: OptumRx.com or 1-800-562-6223
- Specialty Fax: 877-342-4596