University changes health plan provider, prescription costs for some medications may increase| Feb 18, 2016
The University's Student Health Plan replaced provider from Catamaran/Express Scripts with OptumRx to reduce costs, according to Director of University Health Services Janet Finnie.
The change became effective on Jan. 1, although the Student Health Plan Office had made this decision over last summer, she explained. Finnie said discussions and plans for the changeover took place over the course of the Fall semester, after many conversations within the University and with student health groups.
However, medications may now be more expensive than they were before since OptumRx classifies some medications, such as contraceptives, differently than Express Scripts does, Finnie noted.
According to OptumRx policy, under the new plan if a student were to go to a Princeton pharmacy, RiteAid or CVS to fill out a prescription for medications such as birth control, psychotropics or anti-malarial pills for up to 30 days, the co-pay for a generic brand would be $5, a preferred brand would be $20 and a non-preferred brand would be $70, the company’s representative said.
She explained that if the day supply were 31-60 days, these prices would double, and the more the day supplies increase, the more the price will go up. These prices depend on the type of medication being filled out.
Under the Affordable Care Act, health care plans should cover without cost sharing the full range of FDA-identified contraception method.
Finnie explained if students get in touch with their provider or the UHS, they will be able to figure out how to get the best cost for their pharmacy. She added that Express Scripts also had structures which could make medications more expensive, but the health plan office has time to remedy these issues.
According to Finnie, another issue is that a small number of students who had already paid their deductibles in the fall found that the information had not yet transferred over to OptumRx, and thus had to pay the fee twice.
She added that the Student Health Plan Office is working to get refunds for these students.
“With transitions from one plan to another, there are always some bumps in them because it’s a big switch. So we did have some bumps in making the transition, but I think we’re working through most of them,” noted Finnie.
The Student Health Plan Advisory Council, which is related to the benefit plan and holds two meetings each school year to talk about the student health plan, discussed the switch during its Dec. 4 meeting in Nassau Hall, according to Finnie.
Helena Hengelbrok '16, Student Health Advisory Council member, said that Vice President for Campus Life W. Rochelle Calhoun and Vice President for Finance and Treasurer Carolyn Ainslie asked for feedback from 15 administrators, graduate students, undergraduates and UHS representatives who were gathered at the meeting.
Calhoun and Ainslie are the executive sponsors of the Student Health Plan.
Calhoun deferred comment to Finnie.
Ainslie did not respond to a request for comment.
“It seemed like there was room for people to individually advocate for their medicines if they had previously been covered,” Hengelbrok said.
Hengelbrok also said that because of similarities across benefits provided, in reality only a small percentage would be negatively affected by the change.
The University has joined a coalition of other universities that joined together in switching health care providers in order to reduce costs, Finnie explained.
Hengelbrok said another reason for the change, as Calhoun and Ainslie had explained in the meeting, was that Express Scripts was planning on changing its level of coverage and that this new plan was therefore preferable
Annemarie Poemer, a representative from the Student Health Plan office, said currently a total of 4,782 students are on the health plan. Of these students, 1,771 are undergraduates, 2,775 are graduates and 236 are dependents, she said.
“We want to hear from any students who are having any problems and assist them in addressing those concerns so that they are not having financial problems because of this,” Finnie said.