Beginning January 1, 2027, AffirmedRx® will become the University’s new pharmacy benefits manager (PBM). AffirmedRx was selected after a rigorous request for proposal (RFP) process that included faculty, staff, and retirees who sit on the Benefit Advisory Committee. The PBM manages the prescription drug benefit, including the pharmacy network and drug formulary.
We understand that changes can feel stressful, especially when you or a family member relies on regular medications. You may be wondering if your medications will still be covered, if you can continue using your pharmacy, or if you will need to make changes.
Our goal is to make this transition as smooth as possible and minimize disruption to your care. Changing pharmacy providers involves a number of systems and partners, so some details will take time to finalize. We remain on schedule and will share additional information and resources here as soon as they are available.
What to expect
We expect disruptions to be minimal, and most prescriptions will continue to be covered.
The pharmacy network will remain broad, and the current prescription copay structure will continue until you reach the new combined medical and pharmacy out-of-pocket maximum.
You will receive a letter in the mail with more details about the transition in early October. We will also continue to update this webpage as more information becomes available.
Member cost sharing
Select preventive medications specified under the Affordable Care Act will continue to be covered at no charge for you and your family.
For other medications, employees on the HSA medical plan will continue to pay 15% coinsurance for each tier.
All other medical plans will continue to use the following copay structure:
- $10 (Tier 1): Low-cost, generic drugs
- $30 (Tier 2): Higher cost generic and preferred brand-name drugs
- $75 (Tier 3): High-cost drugs, mostly brand-name and specialty drugs
Specialty drugs will continue to be offered through Fairview Specialty Pharmacy along with education and support.
Note: Individual medications may sometimes move from one tier to another based on the formulary. This means the copay for a specific medication could change if its tier changes. However, the copay amounts for each tier will not increase in 2027 for copay plans.
2027 formulary information
We know many employees are eager to see whether their medications will be included in the new formulary. The University’s 2027 formulary is not available yet. We will add a link to the University’s 2027 formulary to this webpage as soon as it is available, which we anticipate will be in late October.
The University’s Total Rewards team is working closely with AffirmedRx to develop and review the future formulary. Our faculty consultant from the College of Pharmacy is also actively involved in this work. Their expertise will help us carefully review the new formulary and advocate for University employees.
Important: Any formulary currently available on the AffirmedRx website is for general purposes only. It is not the University’s formulary and should not be used to determine whether your medication will be covered in 2027.
If you are affected by a change
We expect disruptions to be minimal. If you are affected by a change to your coverage or pharmacy network, AffirmedRx will send a letter to your home later this fall.
The letter will explain what is changing and what, if anything, you need to do. AffirmedRx Member services will be available to answer questions and help navigate the transition. Member services will be available beginning September 15, from 8 a.m.–5 p.m. CT, Monday–Friday.
We know that changing a medication or pharmacy is not always simple. If you receive a letter from AffirmedRx, review the information carefully and follow the instructions provided. You will have time to understand your options and work with your healthcare provider, if needed, before the new benefit takes effect.
We will keep you informed
We are still working through the details of the transition with AffirmedRx. We will share more information as soon as it is available. Check this webpage for updates and other details to help you prepare for the January 1 transition.
For now, you do not need to take any action. Continue to use your pharmacy benefits as you normally do.