Prescription Coverage Made Easier: How to Fill Medications and Get Support

Prescription medications are an important part of staying healthy, whether you are managing a chronic condition or treating something short term. Knowing how prescription benefits work can help you feel more confident at the pharmacy, understand your options, and avoid unnecessary stress when filling a prescription.

This guide is written for health plan members, but it is also helpful for anyone learning how prescription benefits typically work or exploring health coverage options. The goal is simple: to help you get the medications you need in a way that feels clear, supported, and easy to navigate.

Simple ways to make prescriptions easier to manage
No matter what type of health coverage you have, these general tips can help make the prescription process smoother.

• Ask your healthcare provider if generic medication is available. Generics are FDA approved and work the same as brand‑name drugs for most people.
• Use an in‑network pharmacy to help ensure you are utilizing all programs available to you and help to reduce your prescription cost.
• If you take medication regularly, consider mail order delivery for added convenience.
• Review your medications from time to time with your provider to confirm they still meet your needs.
• If something is unclear at the pharmacy, ask questions or reach out for support.

Health plans are designed to support informed choices. Understanding how your benefits work helps you get the most from them.

What prescription drug benefits are and how they support your care
Prescription drug benefits help cover medications prescribed by your healthcare provider. These benefits are part of many employer‑sponsored health plans and are designed to support safe and effective treatment.
Trustmark Small Business Benefits prescription programs are structured to help members understand their coverage, access medications through trusted pharmacies, and receive support when questions arise.

Where you can fill your prescriptions
Your plan offers flexibility in how you receive medications.

Retail pharmacies
Local and national pharmacies are commonly used for short‑term prescriptions or medications that you need to begin taking right away.

Mail order pharmacies
Mail order pharmacies are often used for ongoing or maintenance medications. Prescriptions are shipped directly to your home, usually in a larger supply (Trustmark plans offer up to 90-day supply). This option can make it easier to stay consistent with medications and reduces the need for frequent pharmacy visits.

Specialty Pharmacies
Certain medications require additional handling, storage, or clinical support. These prescriptions are filled through specialty pharmacies that focus on supporting members who take complex or high‑touch medications. Trustmark plans utilize CVS Specialty Pharmacy.

How prescription coverage can differ by plan
Prescription coverage depends on the type of health plan you are enrolled in. Understanding your plan design helps explain how costs are applied and what to expect at the pharmacy.

Some plans use discounted pricing, where members pay a negotiated price for covered medications based on their medical plan benefits.

Other plans include a prescription drug card benefit, allowing members to pay a set copay based on the medication’s tier indicated on the formulary.

Other plans offer access to discounted pharmacy pricing when traditional prescription insurance is not included.

Each approach is designed to support access to medications while keeping the experience straightforward for members.

What a prescription drug formulary means for you
A formulary is the list of medications covered by your health plan. It is reviewed and updated quarterly to reflect new medications, safety updates, and clinical guidance.
Medications on the formulary are grouped into tiers.

Understanding drug tiers

• Tier 1: Generic medications, which are widely used and typically a lower cost
• Tier 2: Preferred brand‑name medications selected for effectiveness and reliability
• Tier 3: Non‑preferred brand medications, which may have alternatives available
• Tier 4: Specialty medications used to treat complex or chronic conditions (Trustmark plans utilize CVS Specialty Pharmacy)

Using lower‑tier medications when appropriate can help reduce out‑of‑pocket costs, but decisions about treatment should always be made with your healthcare provider.

Why some prescriptions require extra review
Occasionally you may need to obtain prior authorization from your physician when filling certain prescriptions. This process is in place to support safe and appropriate medication use.

Reasons for obtaining a prior authorization may include, quantity limits based on clinical guidelines, and encouragement to use FDA‑approved generic alternatives when available.
If you ever have questions about a prescription or next steps, support is available to help guide you. There is a phone number on your Trustmark ID card to reach our Trusted Member Care Team.

Support for specialty medications
Specialty medications often treat complex or serious conditions and may require additional support.

Some Trustmark plans that include a prescription drug card benefit offer access to the PrudentRx® specialty drug savings program. This program works with manufacturer assistance programs to help eligible members reduce their cost for certain specialty medications.

Help when you need it
Prescription benefits can feel complicated, especially when starting a new medication or navigating coverage for the first time. Trustmark’s Trusted Member Care is available to answer questions, explain coverage, and help you understand your options so you feel supported every step of the way. Contact information can be found on your Trustmark ID card.

Prescription benefits designed to support your health
Prescription drug benefits are an important part of overall health coverage. When members understand how their benefits work and where to turn for help, it becomes easier to focus on what matters most: getting the care and medications you need with confidence.

Whether you are enrolled in a Trustmark plan today or learning how prescription benefits work more broadly, understanding these basics can help you make informed healthcare decisions.

About Trustmark^®
Smarter health plans, backed by experience.
For more than 110 years, Trustmark has been a leader in employee benefits, bringing decades of self‑funded expertise to flexible, modern health plans that help employers manage healthcare responsibly.

Trustmark Small Business Benefits® level-funded solutions, which include PPO plans with access to national networks through Aetna Signature Administrators^® and Cigna^® PPO Network, Reference Based-Pricing, and dual-option designs, give employers real transparency, predictable monthly costs, and the potential for surplus refunds. Employees receive benefits they can easily use, and brokers get a partner who has delivered stability and service for decades.