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Prescription Drug Benefit

Also see: Navitus Pharmacy Booklet (2014)

The Vanderbilt Health Plan includes a prescription drug benefit managed by Navitus Health Solutions. The prescription drug benefit is a multi-level formulary* with a recommended generic program.

Not all prescription drugs are covered by the Vanderbilt Group Health Care Plan. Some prescription drugs require prior authorization from Navitus Health Solutions before the prescription can be filled.

For questions regarding your prescription drug program, contact Navitus Health Solutions at 866.333.2757 or at www.navitus.com.

Formulary

The Navitus Formulary list is on the Navitus member website. To access the website:

  1. Go to www.navitus.com
  2. Click on the link for Members and then click on the link for Member Login
    • If you have already registered, enter your User ID and Password. Then answer the security question.
    • If you haven't registered yet, click on the link for Click here for new registrations. You will need your Navitus ID number, found on your Navitus card.
  3. Once you have logged in with your user name and password, you will see the homepage of the Navi-Gate website.
  4. Click on the link for Formulary in the left column.
  5. You can download a Quick Reference Formulary or a Complete Formulary.

If you need help, contact Navitus Customer Care toll-free with the number listed on your Navitus card. Navitus Customer Care is open 24 hours a day, 7 days a week (closed Thanksgiving and Christmas Day).

Specialty Drugs

Coverage of specialty drugs is available only when filled through one of the Vanderbilt pharmacies. Specialty drugs typically treat very serious diseases. They include biotechnologically produced or genetically engineered drugs that require special storage and handling. Please contact Navitus Health Solutions for more information about specialty drugs. Or click here to view the Vanderbilt Specialty Pharmacy Web site.

Drug Manufacturer's Coupons

The Vanderbilt Health Plan does not allow pharmacies to accept drug coupons for prescriptions because drug manufacturers promote their drugs with these coupons, which generally are more costly than a generic equivalent or a preferred drug for the Plan. While the patient’s use of a coupon will lower his/her own out-of-pocket cost, it lessens the patient’s responsibility as an active participant in Vanderbilt’s self-insured Health Plan. Vanderbilt University pays the remaining cost whether or not coupons are used, yet pharmaceutical companies are trying to increase their utilization with these coupons, which drives up the cost to the Plan.

Vanderbilt and In-Network Pharmacies

The Vanderbilt Health Plan encourages faculty and staff to use the Vanderbilt pharmacies, where you will get the $1 maintenance generics and the best price for all other prescriptions. The Vanderbilt pharmacies are located in:

  • The Vanderbilt Clinic
  • Medical Center East
  • Monroe Carell Jr. Children's Hospital at Vanderbilt
  • Vanderbilt Health One Hundred Oaks

The Navitus pharmacy network is also available and includes most major retail pharmacies. Click here for a list of major retailers in the Navitus network.

Mail Order Service

Mail order service is available through the Vanderbilt Mail Order Pharmacy and is an easy way for you to purchase a 90-day supply of your long-term or maintenance medications. The prescriptions can be mailed to your home or picked up at the Vanderbilt Pharmacy of your choice.

For more information on how to start the mail order service, call the Vanderbilt Pharmacy mail order service at 615.875.0078 or visit the Vanderbilt Ambulatory Pharmacy Services Web page.

* The Formulary is the list of drugs covered under the Vanderbilt Health Care Plan

Navitus Contact Information


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