When you enroll in the Inova medical plan, you automatically receive prescription drug benefits through Capital Rx. Prescription drug coverage is included in the contributions you pay for medical coverage.
With your prescription drug benefits, you also have access to Inova Pharmacy Plus — allowing you to get your prescription medications and other health care supplies before you leave the hospital.
Drug tiers
The cost of your prescription drugs depends on the tier of the medication — generic, preferred, or non-preferred. All prescription carriers have a formulary, or list of preferred drugs based on effectiveness and cost.
Generic drugs
Same active ingredients as brand-name equivalents and meet the same standards for quality and effectiveness, but usually cost much less.
You pay: $
Preferred drugs
Brand-name medications included on the formulary and favored by your prescription carrier.
You pay: $$
Non-preferred drugs
Brand-name medications not preferred by your carrier. They may still be covered, but may require prior authorization and cost more.
You pay: $$$
Check the formulary
See how medications are covered by logging in to your prescription account on the Capital Rx website.
Benefits at-a-glance
| Up to a 30-day supply | Inova Pharmacy Plus | Retail Pharmacy |
|---|---|---|
| Generic | $5 | $10 |
| Preferred Brand* | 20% ($20 minimum/$50 maximum) | 20% ($25 minimum/$80 maximum) |
| Non-Preferred Brand | 30% ($55 minimum/$100 maximum) | 35% ($75 minimum/$120 maximum) |
| Up to a 90-day supply | Inova Pharmacy Plus | Retail Pharmacy |
| Generic | $15 | $30 |
| Preferred Brand* | 20% ($50 minimum/$125 maximum) | 20% ($65 minimum/$200 maximum) |
| Non-Preferred Brand | 30% ($150 minimum/$250 maximum) | 35% ($190 minimum/$300 maximum) |
*If you elect to purchase a brand-name drug when a generic alternative is available, you will be required to pay the brand cost sharing, plus the difference between the cost of the brand-name drug and its generic equivalent. There are no exceptions.
Specialty Drugs
All prescriptions for specialty medication, such as those used to treat complex conditions like rheumatoid arthritis, multiple sclerosis, or psoriasis, must be filled through Inova Pharmacy Plus.
| Specialty Drugs (up to a 30-day supply)* | Inova Pharmacy Plus |
|---|---|
| Specialty Preferred Brand | 30% ($100 maximum) |
| Specialty Non-Preferred Brand | 30% ($200 maximum) |
*Specialty medications (typically injectable and oral drugs) must be filled through Inova Pharmacy Plus. For more information, contact Inova Pharmacy Plus at 1-571-472-1100 and select option #9.
NOTE: There is a $20,000 lifetime maximum benefit for fertility drugs.
Important reminder for team members enrolled in Innovation Health HSA HDP (High Deductible Plan) or Outside NOVA HSA HDP
If you are enrolled in the Innovation Health HSA HDP (High Deductible Plan) or Outside NOVA HSA HDP, you will pay the full price for all prescriptions until you meet your medical plan deductible. Once you’ve met your deductible, you will be charged the copays shown. Note that the deductible will be waived for drugs on the Preventive Therapy List available on Capital Rx. Participants in the Innovation Health PPO or Outside NOVA PPO plans do not have to meet their deductible before copays apply for prescription coverage. However, prescription copays do not apply toward the deductible for the Innovation Health PPO or Outside NOVA PPO.
Save money on your prescriptions!
The cost of prescription drugs is rising faster than many other health care services and supplies. But, there are ways for you to save.
- Ask your doctor about generic medications. Generic medications are generally just as effective as brand-name medications, but they typically cost between 80% and 85% less.
- Take advantage of Inova Pharmacy Plus. As a team member, you get the best benefit by using Inova Pharmacy Plus versus filling with outside pharmacies. Learn more.
Maintenance Medications
You are required to receive a 90-day supply of a maintenance medication after your second fill of a 30-day supply. You can fill these prescriptions through Inova Pharmacy Plus location, including the:
- Inova Heart and Vascular Institute
- Inova Fair Oaks Hospital
- Inova Schar Cancer Institute
- Inova Loudoun Hospital
You can also fill prescriptions through Optum Home Delivery mail service. If you do, you will pay the mail order cost sharing for the 90-day supply. To get started with your maintenance medication fills, contact Inova Pharmacy Plus or Optum Home Delivery directly.
As a team member, you get the best benefit by using Inova Pharmacy Plus versus filling with outside pharmacies. The specialty pharmacy team will help you obtain insurance approvals, provide financial assistance, side effect management, refill coordination, home delivery and on call or scheduled conversations with a clinical pharmacist to coordinate your care. All services are provided at no cost to you! The Inova Pharmacy Plus brochure contains important information regarding filling your medications through Inova Pharmacy Plus.
Other benefits include:
- Lower copays on your medications including big savings on filling your specialty medications.
- Walk-in immunizations — $0 copay on flu, pneumonia and Tdap, low copay on shingles.
- 90-day maintenance medications may be mailed to your home at no charge to you.
- Improved patient education and support — access to assistance programs/copay assistance.
- Text messaging refill reminders, auto refill, prescription ready reminders and Refill Pro App
- One Team — nurses, physicians, pharmacy, case managers, financial aid
- On-call pharmacist support 24/7
Inova Pharmacy Plus is a retail pharmacy with all the services of a neighborhood pharmacy in four convenient Inova locations:
| Pharmacy | Address | Phone and Fax | Location | Hours of Operation |
|---|---|---|---|---|
| Inova Pharmacy Plus — IFOH | 3600 Joseph Siewick Dr | Phone: 703-391-3080 | Inside Inova Fair Oaks Hospital | Monday – Friday: 9am to 6pm |
| Inova Pharmacy Plus — IHVI | 3300 Gallows Rd | Phone: 703-776-8250 | Inside Inova Fairfax Hospital at | Open 7 days a week: 8am to 8pm |
| Inova Pharmacy Plus — ISCI | 8081 Innovation Park Dr | Phone: 571-472-1100 | Inside the Cancer Institute | Monday – Friday: 8am to 6pm |
| Inova Pharmacy Plus — ILH | 3300 Gallows Rd | Phone: 703-858-6020 | Inside Inova Loudoun Hospital | Monday – Friday: 9am to 7pm; Saturdays and Sundays: 9am to 3pm |
Order your prescriptions through Inova Pharmacy Plus
To order your prescriptions through Inova Pharmacy Plus, contact any of the pharmacy locations listed above to transfer a current prescription from another pharmacy. You may also have your physician e-prescribe, call or fax in a script. For more information, go to Inova Pharmacy Plus.