Prescription Drugs

What You Need to Know

When you need a prescription filled, your most convenient option will be the Student Health Pharmacy, where your copay will typically be lowest.

OptumRx administers your pharmacy benefit, so when you’re away from campus and need a prescription filled, you’ll usually pay less when you use a retail pharmacy in the OptumRx nationwide retail pharmacy network versus an out-of-network pharmacy.

If you have your prescription filled at a pharmacy outside the SHC, be sure you show your Anthem member ID card.

How Your Prescription Drug Coverage Works

What you pay for your prescription (your copay) is based on medication type: generic, brand-name formulary, brand-name non-formulary, or specialty. The formulary [PDF] is the list of medications that UC SHIP covers.

What you pay for prescription drug costs counts toward your annual out-of-pocket limit. Once your costs reach that limit, UC SHIP steps in to pay 100% of your pharmacy costs.

Oral Contraceptives Are Free

You’ll pay nothing for FDA-approved generic oral contraceptives and brand-name oral contraceptives (when there’s no generic equivalent). Coverage is for a 180-day supply.

You’ll find coverage details below. For more information, review the UC Santa Barbara Prescription Drug Plan booklet [PDF].

Your annual limit on out-of-pocket costs includes your prescription drug copays and medical costs.

Student Health Pharmacy

Copays below are for a 30-day supply.

Generic Drugs
Brand-Name Formulary Drugs
Brand-Name Non-Formulary Drugs
Specialty Medications
Copay
$5 copay
$25 copay
$40 copay
$40 copay
Network Pharmacies

Network pharmacies include retail pharmacies in the OptumRx network, including CVS and Walgreens. To find a list of OptumRx pharmacies near you, sign in to the OptumRx website.

Annual Limit on Your Out-of-Pocket Costs (combined with out-of-network pharmacy costs)
You Pay
Individual: $6,600
Family: $13,200

Copays below are for a 30-day supply.

Generic Drugs
Brand-Name Formulary Drugs
Brand-Name Non-Formulary Drugs
Specialty Medications
Copay
$5 copay plus 50% of drug cost
$25 copay plus 50% of drug cost
$40 copay plus 50% of drug cost
$40 copay plus 50% of drug cost

Out-of-Network Pharmacies

When you fill your prescription at an out-of-network pharmacy, you will pay the entire amount of the prescription and then submit the online OptumRx prescription drug claim form for reimbursement. You can also download a PDF of the OptumRx prescription drug claim form [PDF]. The pharmacist must complete and sign the claim form to ensure the claim is properly processed. Your reimbursement could be less than what you paid for the medication.

Annual Limit on Your Out-of-Pocket Costs (combined with network pharmacy costs)
You Pay
Individual: $6,600
Family: $13,200

Copays below are for a 30-day supply.

Generic Drugs
Brand-Name Formulary Drugs
Brand-Name Non-Formulary Drugs
Specialty Medications
Copay
$5 copay1
$25 copay plus 50% of drug cost1
$40 copay plus 50% of drug cost1
$40 copay plus 50% of drug cost1
1. You will also pay any amount above the OptumRx maximum allowed amount.

Contacts

Student Health Services (SHS)

Your first stop for care on campus
Main number: (805) 893-3371
Counseling and Psychological Services (CAPS): (805) 893-4411
Alcohol and Drug Program: (805) 893-5013
SHS website
SHS email
M/C 7002
Santa Barbara, CA 93106-7002

OptumRx

Prescription drug plan benefits
(844) 265-1879