Prescription drugs purchased from outside of the U.S. (for example: Mexico or Canada) are not covered under the Healthy Directions benefit plans

Therefore, your cost will not be applied toward your deductible. According to the IRS, these types of purchases are not considered qualified medical expenses, so HSA dollars cannot be used for them.
You can compare the cost of medications at local pharmacies through an online tool on www.myuhc.com. You can also see the cost difference between mail-order prescriptions and prescriptions you would pick up at a pharmacy

To use www.myuhc.com, you will need to register online. This takes only a few minutes. Once you register, your personal information will appear. It includes information available since you became a UHC member such as:

• The status of any processed claims (since 01 January 2007)
• Information about your qualified dependents (since 01 January 2007)

On www.myuhc.com, you can compare the cost of medications by starting at the home page and
1. Hover cursor over the “prescriptions” tab
2. Click on “Drug/Pricing Coverage”
3. Click on “Go to pharmacy online”

You can enter the names of any prescriptions you would like to price, the dosage, and at which pharmacy you would like to check the pricing. This will give you a cost estimate between mail-order prescriptions and retail.

You can also use the Savings Advisor on www.myuhc.com to compare prescription costs.

You can compare the cost of prescriptions you are currently using to comparable prescriptions

The Savings Advisor Tool on www.myuhc.com allows you to view prescriptions similar to prescriptions you may already be taking. To access the Savings Advisor Tool on www.myuhc.com, start at the home page and
1. Hover cursor over the “prescriptions” tab
2. Click on “Drug/Pricing Coverage”
3. Click on “Go to pharmacy online”
4. “Savings Advisor” is an option under “Planning and Reference” on the left navigation pane

The tool provides information to understand alternative treatment options to discuss with your provider. What works best for you is between you and your physician and may vary on your situation.

Some nation-wide pharmacy chains are offering generic prescriptions for $4

Some national pharmacy chains have announced a special $4 per prescription generic pharmacy program. This is a way for you to save money on some of the most common generic prescriptions.

If you take advantage of this program, the pharmacy may choose not to file your claim with UnitedHealthcare. To view your claims, go to www.myuhc.com.

If your prescription is not filed with UHC, you can submit the claim to UHC by filing the receipt and a claim form. The claim submission form can be found on www.myuhc.com. Once logged in to myuhc.com, hover over “Prescriptions” and select “Drug Pricing/Coverage.” From there, select “Go to Pharmacy Online,” and select “Forms and Cards” in the left side navigation panel. This is where the claim submission form can be found.

Prescriptions are limited to 31-day or 90-day supplies
The John Deere benefit plan limits prescriptions to either a 31-day or 90-day supply. A 150-day supply of a prescription is not covered. The reasons for this include the safety of the patient and cost considerations. For example:
• Patient Safety - In terms of patient safety, certain drugs require quantity limits or prior authorizations. The quantity limits provide for a systematic check on proper medication usage. If patients try to refill their prescription before the expected refill time, it allows for an early warning to the pharmacist to talk to the patient about their medications.
• Wasted Prescriptions - With so many maintenance medications issued, oftentimes new medical conditions or drug regimen changes force patients to discontinue a medication. The cost of the unused medication is then wasted. Therefore, a 90-day supply balances the cost savings versus the cost of wasted medications.

Myuhc.com contains tools to help you compare costs for treatments and procedures, organize your medical claims online, order and renew prescriptions online, get information about hospitals and physicians and more
Myuhc.com offers tools and information for UHC members. A short, online registration will give you access to the tools. You will also be able to view your personal profile and other information such as:
•    The status of any submitted claims (since 01 January 2007)
•    Information about your qualified dependents, including coordination of benefits information

Some of the things you can do at myuhc.com are:
•    Compare in- and out-of-network costs for particular procedures. (Select: Treatment Cost Estimator or Plan Comparison Calculator)
•    View and print copies of your paid medical claims. (Select: Claims Center)
•    Order and renew prescriptions online, learn about drug side effects and interactions. (Select: Pharmacy Online)
•    Evaluate hospitals on quality of care and patient safety measures. Identify in-network physicians and hospitals. (Select: Hospital Comparison Tool or Find a Physician)
•    Print a temporary medical ID card or request a replacement card. (Select: Manage My Account)

Some health care providers may continue to charge you even after you have met your deductible
Most providers will bill your insurance first, and then bill you for any portion of expenses not covered by the deductible. However, occasionally some providers will ask for payment up front, even if you have met your deductible.

You will need to discuss with your health care provider how they choose to bill/receive payment when you receive services.

If you have met your deductible and you pay your provider, UnitedHealthcare will reimburse you (as long as the provider indicates on the claim form that you have paid).

You can see online where you are in relation to meeting your deductible
You can track your deductible and claims status by going to www.myuhc.com. UHC will process claims submitted against the plan provisions.

The UnitedHealthcare monthly health statement replaces individual Explanation of Benefits (EOB) statements
Instead of receiving a separate EOB statement for each claim, you will be mailed one statement each month that consolidates all processed claims for that period, as well as remaining balances for deductibles and out-of-pocket expenses.

Your UHC monthly health statement is a recap of all services for each covered individual in your household. It itemizes all out-of-pocket expenses for the month and provides you with a year-to-date summary helping you see the complete picture of your health care spending.

Not all health care providers are included in the Choice Plus network
You can use out-of-network providers, but there are things you need to consider.
Although UnitedHealthcare’s Choice Plus network is broad, not all providers are included. To view which providers are in-network, go to www.myuhc.com.

If you use an out-of-network provider, you pay 100 percent of allowed medical services up to the deductible. The out-of-network deductible is higher than the in-network deductible. Once you reach the deductible, the plan pays for 50 percent for allowed out-of-network medical services. You pay the remaining 50 percent. And, there is no out-of-pocket maximum.

Claims filed with UnitedHealthcare of the River Valley (formerly known as John Deere Health) are treated differently than claims with UnitedHealthcare since 01 January 2007
If you were a member of UHC of the River Valley (formerly John Deere Health), any claims with the date of service on or before 31 December 2006 are processed through the UHC of the River Valley location in Moline.

Any claims with the date of service on or after 01 January 2007 are processed through UnitedHealthcare at the location listed on your UHC member ID card (if it’s a medical claim) or the location listed on your UHC dental ID card (if it’s a dental claim). You may visit www.myuhc.com to check the status of medical and dental claims. You may call UHC at 1-888-JDEERE1 (1-888-533-3731) with claim issues from 2007.

You have two UnitedHealthcare member ID cards - one for medical and one for dental
UnitedHealthcare uses separate claims service centers for medical and dental. Your provider will need to submit medical claims to the address found on the back of your UHC medical ID card and dental claims to the address on your UHC dental ID card.

You can change your health care benefit election if there is a qualifying family status change
If you experience a qualifying family status change (for example, having a baby, getting married, getting a divorce, etc.), you can change your health care coverage election. In all cases, a change in your coverage category or medical option must be due to and consistent with your change in family status. The new HSA limit, communicated in January 2007, is not a qualifying family status change, and therefore you cannot change medical plan options due to this recent change. You may contact Deere Direct at 1-888-432-3373 on what is considered a qualifying family status change.

UnitedHealthcare’s pharmacy management program provides clinical pharmacy services that promote choice, accessibility and value. The program offers a broad network of pharmacies (more than 50,000 nationwide) to provide convenient access to medications.

While most pharmacies participate in our network, you should check first. Call your pharmacist or visit our online pharmacy service at www.myuhc.com. The online service offers you home delivery of prescriptions, ability to view personal benefit coverage, access health and well being information, and even location of network retail neighborhood pharmacies by zip code.

Copayment per Prescription Order or Refill

For a single Copayment, you may receive a Prescription Drug Product up to the stated supply limit. Some products are subject to additional supply limits. You are responsible for paying the lower of the applicable Copayment or the retail Network Pharmacy’s Usual and Customary Charge, or the lower of the applicable Copayment or the mail order Pharmacy’s Prescription Drug Cost.

Also note that some Prescription Drug Products require that you notify us in advance to determine whether the Prescription Drug Product meets the definition of a Covered Health Service and is not Experimental, Investigational or Unproven.

Our Preferred Drug List includes those drugs available to you at the most affordable cost. It is one of the best ways to maximize your prescription drug benefits. The drug list, developed by physicians and pharmacists on our national Pharmacy and Therapeutics committee, includes a wide selection of generic and brand name prescription medications commonly prescribed by physicians. The Preferred Drug List is updated throughout the year. The most current version is available at our online pharmacy at www.myuhc.com

Other Important Cost Sharing Information
If you purchase Prescription Drug Product from a Non-Network pharmacy, you are responsible for any difference between what the Non-Network pharmacy charges and the amount we would have paid for the same Prescription Drug Product dispensed by a Network pharmacy.

Exclusions from coverage listed in the Certificate apply also to this Rider. In addition, the following exclusions apply:
•    Coverage for Prescription Drug Products for the amount dispensed (days supply or quantity limit) which exceeds the supply limit.
•    Drugs which are prescribed dispensed or intended for use while you are an inpatient in a Hospital, Skilled Nursing Facility, or Alternate Facility.
•    Experimental, Investigational or Unproven Services and medications; medications used for experimental indications and/or dosage regimens determined by us to be experimental.
•    Prescription Drug Products furnished by the local, state or federal government. Any Prescription Drug Product to the extent payment or benefits are provided or available from the local, state or federal government (for example, Medicare) whether or not payment or benefits are received, except as otherwise provided by law.
•    Prescription Drug Products for any condition, Injury, Sickness or mental illness arising out of, or in the course of, employment for which benefits are available under any workers’ compensation law or other similar laws, whether or not a claim for such benefits is made or payment or benefits are received.
•    Any product dispensed for the purpose of appetite suppression and other weight loss products.
•    A specialty medication Prescription Drug Product (such as immunizations and allergy serum) which, due to its characteristics as determined by us, must typically be administered or supervised by a qualified provider or licensed/certified health professional in an outpatient setting.
•    This does not apply to Depo Provera and other inject able drugs used for contraception.
•    Durable Medical Equipment, Prescribed and non-prescribed outpatient supplies, other than the diabetic supplies and inhaler spacers specifically stated as covered.
•    General vitamins, except the following which require a Prescription Order or Refill: prenatal vitamins, vitamins with fluoride, and single entity vitamins.
•    Unit dose packaging of Prescription Drug Products.
•    Medications used for cosmetic purposes.
•    Prescription Drug Products, including New Prescription Drug Products or new dosage forms, that are determined to not be a Covered Health Service.
•    Prescription Drug Products as a replacement for a previously dispensed Prescription Drug Product that was lost, stolen, broken or destroyed.
•    Drugs available over-the-counter that does not require a Prescription Order or Refill by federal or state law before being dispensed. Any Prescription Drug Product that is therapeutically equivalent to an over-the-counter drug. Prescription Drug Products that are comprised of components that is available in over-the-counter form or equivalent.
•    Prescription Drug Products when prescribed to treat infertility.
•    Prescription Drug Products for smoking cessation.