AMT has established The AMT Agency, LLC to provide employers and brokers access to a full suite of benefit programs.

Read our notice to learn more.

Horizon Employer Choice, an Individual Coverage Health Reimbursement Arrangement is now available.

Read our notice to learn more.

New voluntary benefits are now available to AMT employer groups through The AMT Agency and MetLife. Learn more:

https://theamtagency.com/voluntary-benefits-from-metlife
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About Our Prescription Benefits

As an AMT member, your relationship with your Association is a key advantage. Our prescription benefits are a testament to the value of this relationship, with AMT offering self-funded programs that provide comprehensive, competitive, and flexible healthcare options. This partnership ensures you have access to a wide network and a range of plan options that prioritize you and your employee’s health and well-being.

Prescription Benefits

Our prescription coverage is designed to help employers save time and money while ensuring all your employees have the medications they need.

Cost Savings

Use generic drugs whenever possible to help reduce out-of-pocket costs.

Mail Order Convenience

Receive a 90-day supply of maintenance medications delivered right to the member’s door.

Broad Network Access

Fill prescriptions at a nationwide network of pharmacies, including both retail and mail-order options.

Seamless Integration

The members’ prescription costs apply toward their medical plan’s Maximum Out-of-Pocket limit, ensuring all their health expenses are coordinated.

Prescription Benefit Options & Types

We offer a variety of medical plans to suit your needs, with comprehensive prescription benefits built into each one. The primary difference between benefits is how you share the cost, either through a fixed co-payment or a percentage-based co-insurance. Please review the information below and contact your administrator to discuss which medical plan is the right fit for you.

This benefit offers coverage for a wide range of generic, preferred brand, and non-preferred brand drugs using a percentage-split co-insurance structure. This means your employees pay a percentage of the drug's cost. Specialty drugs are covered at retail in network only in applicable categories.

This benefit is similar to the 1-Tier Rx benefit but also includes coverage for specialty drugs within a percentage-split co-insurance structure. Specialty drugs are covered at retail in OMNIA Tier 1 and Tier 2 only .

This benefit provides a fixed copay for all drug types. Generic drugs are covered at a lower fixed cost, while preferred and non-preferred brand drugs are covered at a higher, fixed cost. Specialty drugs are covered at retail in network only in applicable categories.

This benefit offers a three-tiered split copay for all drug types, with different fixed costs for generic, preferred brand, and non-preferred brand drugs. Specialty drugs are covered at retail in network only in applicable categories.

This benefit is similar to the 3-Tier Rx benefit, but specialty drugs are covered at retail in OMNIA Tier 1 and Tier 2 only in applicable categories.

This hybrid benefit provides a fixed copay for generic drugs, but a percentage-split co-insurance for preferred and non-preferred brand drugs. Specialty drugs are covered at retail in OMNIA Tier 1 and Tier 2 only in applicable categories.

This hybrid benefit provides a fixed copay for generic drugs and a percentage-split co-insurance for preferred brand, non-preferred brand, and specialty drugs. Specialty drugs are covered at retail in OMNIA Tier 1 and Tier 2.

Prescription Benefit Features

AMT’s prescription drug benefits go beyond simple coverage, providing resources and tools to help members effectively manage their medication and health. Our benefits are designed to offer support and ensure that members are well informed.

Prior Authorization

Certain drugs may require prior approval to ensure they are medically necessary and covered.

Generic Substitution

Mandatory generic drug substitution is required unless specifically prohibited by the member’s healthcare provider.

Out-of-Network Costs

Additional charges and limitations may apply for prescriptions filled at out-of-network pharmacies.

FlexAccess Program

This program may contact the member for certain qualifying drugs to offer copay assistance from the drug manufacturer.

Prime Therapeutics

AMT partners with Prime Therapeutics as its pharmacy benefit manager to manage drug coverage and provide members with a portal to access information.

Maximum Out-of-Pocket (MOOP)

All prescription costs count toward the member’s medical plan's MOOP, helping them manage their total annual healthcare expenses.

Get a Personalized Health Plan Quote Today!

Explore how AMT’s self-funded solutions can help your business save on healthcare costs while ensuring top-quality benefits for your employees.

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