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Pharmacies and Prescriptions

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Essentia Health

Pharmacy Benefits

Your Essentia Health plan includes coverage of prescription drugs. Learn more about how your pharmacy benefits work using the resources below.

Pharmacy Locations

Essentia Health offers several options to best meet your pharmacy needs. To find a pharmacy use the resources below.

You’ll receive your highest benefit level when you fill prescriptions at Essentia owned pharmacies or Tier 1 pharmacies.

You can also fill prescriptions with pharmacies in the Broad Access network:

Drug List

Covered drugs are shown on the drug list. The list includes both brand-name and generic drugs, and is reviewed and updated regularly by a group of independent physicians and pharmacists. Your doctor can use this list to choose medications that are right for you.

The drug list will also show you medication that is not covered — become familiar with how the drug list works.

Drugs are covered based on their tier designation:

  • Tier 1, Tier 2, and Tier 4 are covered medications.
  • Tier 3 or Tier 5 are not covered by the plan and you will be responsible to pay the full cost of these medications. 

Learn more by reading the Introduction and Preface sections of the drug list below. 

Drug list (PDF)

Mail Order Pharmacy

Long-term, maintenance medications

You can purchase long-term medications, or "maintenance medications," in 93-day supplies at any Essentia Health or Dakota pharmacy or through Essentia Health Mail Order. 

Essentia Health mail order

If you have prescriptions for a long-term condition, getting your medication through the mail may be a convenient option for you. 

Essentia Health Mail Order is a quick and easy way to fill your regular prescriptions, saving you time. Stop in at any Essentia Health owned pharmacy (including Dakota pharmacies) or fill out the online refill form to transfer your prescriptions and they'll be sent directly to you. In most cases, your prescriptions should arrive in two to three business days.

To fill a new prescription or transfer an existing prescription to Essentia Health Mail Order:

Specialty Drugs

Specialty drugs are medications that require special handling, administration, or monitoring, and are often used to treat complex or chronic conditions. Most specialty drugs are required to be dispensed through Essentia's own specialty pharmacy. This requirement ensures the outcome of care is the best it can be.

If you need to fill a new specialty drug:                

  1. View the drug list to see what drugs are covered. Specialty drugs are noted with “SP” on the drug list.
  2. Have your prescription filled through Essentia Health’s specialty pharmacy. Call the Essentia Health Specialty Pharmacy at 844-380-5626 if you have questions.

Specialty Drug List (PDF)

Preventive Drug Coverage

My Essentia Choice Care HDHP and My Essentia Choice Care HDHP Basic have separate coverage for preventive maintenance drugs. These drugs are used to treat common conditions such as coronary artery disease, diabetes, high blood pressure, depression and respiratory disorders. Unlike other medications, you will not have to pay your deductible first when you need to take a drug on the preventive drug list.

Log in to your secure member site to check your plan's coverage for preventive maintenance drugs.

Log in to mymedica

You can also view the preventive drug list for HSA plans to see which drugs are considered preventive maintenance drugs.

Medica Preventive Drug List (PDF)

 


 

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