What’s New for 2022

There are no changes to the plans’ copay or coinsurance structure or to what the medical plans cover.

However, you should take note of other important changes that affect all plans.

New Pharmacy Benefit Manager

Navitus Health Solutions (Navitus) is replacing Anthem IngenioRx as the administrator of the UC PPO plans prescription drug benefit. As the new pharmacy benefit manager, Navitus will set clinical policy and guidelines for medications and will process pharmacy-related claims.

After a thorough review process, a committee representing faculty, staff and retirees determined that Navitus would offer significant advantages as the pharmacy benefit manager, helping ensure employees and their families receive the highest levels of service at the most competitive prices for needed medications.

Continued Focus on Service and Convenience

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Navitus offers members convenient and familiar options for filling prescription drugs, including UC pharmacies, a large retail network, mail order delivery, and access to specialty medications.

Navitus will also provide robust support to help you better understand and manage your prescription drug benefit, including 24/7 Customer Care, a member-focused website, and a mobile app for easy access to all your prescription medication information.

  • 24/7 Customer Care. Beginning October 1, Navitus Customer Care can answer your pharmacy benefit questions, advise you about taking your medications correctly, and help you get additional care if needed. Their toll-free number is (855) 673-6504 and they are available 24 hours a day, 7 days a week, except on Thanksgiving and Christmas Day. TTY users can call 711.
  • Online tools to make the most of your prescription benefit, including a pharmacy locator, cost compare tool, and educational resources to help you manage your health.
  • Navitus+ app. Access your benefits, locate a nearby pharmacy, view and manage your medications, and more. (Note: Pharmacy information will not be displayed on the Anthem Sydney Health app after December 31, 2021.)

Learn more about what’s covered, your costs, and find in-network pharmacies near you.

Costs and Formulary Changes

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There are no changes to the prescription drug copay (for the UC Care plan) or coinsurance amounts (for the UC Health Savings Plan and CORE plan). However, every prescription benefit manager uses its own formulary, which is a list of drugs that are covered by the plan. While the Anthem IngenioRx and Navitus formularies are similar, there are some differences, which could affect your individual medication costs. You can review the Navitus formulary to confirm how your existing medications are covered.

UC Care Members: Navitus may classify drugs differently, which could affect your out-of-pocket costs. For example, both the Anthem and Navitus formularies feature four tiers of medications (including generic, preferred, non-preferred brand-name drugs, and specialty medications). However, the drugs that are included on the Navitus 4-tier formulary differ from those included on the Anthem 4-tier formulary. This means that you might pay more, or less, for your prescriptions than you do today.

But don’t worry. In most cases, if you are taking a drug that will not be covered or will be in a higher tier under the Navitus formulary, Navitus will contact you in December to explain your options. (It is possible that you will not be contacted if you begin a new drug late in the year.)

Filling Prescriptions

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Navitus offers members convenient and familiar options for filling prescription drugs, including:

  • Retail network. A large national network including chains such as Costco, CVS, Walgreens, Walmart, and Safeway/Vons, as well as many independent pharmacies and walk-up pharmacies located within the University of California (UC) Health Medical Centers. View Navitus participating pharmacies. Find a pharmacy.
  • Mail order. Costco Pharmacy will fulfill mail order prescriptions beginning January 1, 2022. Remember that you can have a 90-day supply of eligible medications mailed to you at 2x the 30-day-supply copay (instead of 3x the 30-day-supply copay if you fill prescriptions at retail pharmacies). You don’t have to be a Costco member to use the mail order pharmacy, but you will have to register with the Costco mail order pharmacy after January 1, 2022.
  • Specialty pharmacy. Lumicera Health Services will fill specialty medication prescriptions beginning January 1, 2022. Specialty medications treat certain chronic illnesses or complex diseases such as rheumatoid arthritis, multiple sclerosis, cancer and hepatitis C. You will also be able to obtain many specialty medications through select UC Health Medical Center pharmacies.

Transferring Prescriptions

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Mail order: Most open mail order prescriptions will be automatically transferred to the Navitus mail service vendor, Costco. You don’t have to be a Costco member to use the mail service pharmacy. However, you will need to set up an account with the Costco Mail Order Pharmacy and set up your profile, including noting any medication allergies.

Transition Tips

Get a refill for your daily medications. Refill current medications to last through the holidays and new year.

Check the Navitus formulary and drug costs. Review the Navitus formulary to confirm the status of your current medications. You can use the Navitus Cost Compare tool to view 2022 prescription costs.

Find an in-network pharmacy near you. View the Navitus network.

New ID Cards

The change in pharmacy benefit manager also means that all UC Care, Health Savings Plan, and CORE plan members will receive a new member ID card to use beginning January 1, 2022. You should receive your new ID card from Anthem in December, which you will use for all medical and pharmacy services. Your new ID card contains information to help your pharmacist process your prescriptions through Navitus.

New Mental Health Resource

Learn to Live will replace the myStrength app in January 2022. Built on the proven principles of cognitive behavioral therapy (CBT), Learn to Live digital tools are available anywhere, anytime. They can help you identify thoughts and behavior patterns that affect your emotional well-being — and work through them. You’ll learn effective ways to manage stress, depression, anxiety, substance use, and sleep issues. Benefits include:

  • Personalized, one-on-one coaching by teaming up with an experienced coach who can provide support and encouragement by email, text or phone
  • Add friends or family members as “teammates” to help you stay motivated and accountable while you work through programs
  • Live and on-demand webinars to learn how to improve mental well-being with useful tips and advice from experts


Save More in Your Health Savings Account

Health Savings Account contribution limits for 2022 are increasing $50 for self-only coverage — from $3,600 to $3,650 — and $100 for family coverage — from $7,200 to $7,300. Employees age 55 and older can save an additional $1,000 a year.

The Health Savings Account is available only to UC Health Savings Plan members.