Pharmacy Formulary
Employees and dependents covered under the Arkansas State University System's health plan utilize the pharmacy formulary that is managed by UAMS EBRx. Claims are processed through MedImpact.
Visit www.medimpact.com to check medication formulary, drug prices, enroll in the mail order program or locate network pharmacies. To register use the ID number on your medical card, but exclude the first three letters (XCU) or call 877-391-1099
Contact EBRX at 833-339-8402 for questions including coverage, appeals or exceptions.
Most drugs covered under the formulary may be filled at in-network pharmacists by paying the following copays:
| $12 Tier 1 (generic) |
| $50 Tier 2 (preferred) |
| $80 Tier 3 (non-preferred) |
| $100 Tier 4 (specialty) |
| $0 for copay for some preventive Rx |
Deductible and/or coinsurance will apply for Health Savings Plan members.
Some drugs require additional approval in order to be covered under our plan. These include:
- Some drugs require step therapy. Step therapy ensures that members use clinically appropriate drugs in a cost-effective manner by requiring the member to try a generic medication prior to obtaining the brand medication in certain drug classes.
In an effort to control pharmacy costs, sometime a drug may be removed from the formulary if another drug from another manufacturere is available at a lower price. If you are currently taking a drug that is going to be removed, you and your physician will receive a 60 day notification so that your physician may change your prescription to the alternative medication.
Some contraceptives and other preventive medications have a $0 copay.
Revised 01/08/2021
