Health Plans & Prescription Coverage

Eligible employees have the choice between two medical plans which are administered by Capital District Physicians Health Network (CDPHN): Rensselaer Health Plan (RHP) and Rensselaer HMO. Both plans include prescription drug coverage administered by CVS Caremark, the cost of which is included in the employee’s medical plan premium.

Employees should refer to the Benefits Guide and additional documents referenced below for specific health and prescription coverage information and costs.

CDPHP members have access to the national network of providers. Use CDPHP's Find A Doc tool to search.

Under the Rensselaer HMO plan, the plan pays for the employee’s care regardless of the nature or extent of treatment, except for any small co-payments the employee may need to make. There are no claim forms or deductibles for the HMO plan. Employees who choose to join the HMO plan must have all care coordinated by their Primary Care Physician (PCP). Employees may also assign and change their PCP at any time online or by contacting Member Services.

Employees who do not coordinate their care through their PCP will be responsible for paying the full cost of all care, although there are certain exceptions for emergencies.

The Rensselaer Health Plan (RHP) offers in- and out-of-network coverage. Rensselaer employees who decide to use a doctor or facility outside the network — or who see a network provider without a referral from their PCP — will still receive benefits from the plan, but they will pay a larger share of the costs, and you will have to file a claim for reimbursement.

Rensselaer employees who live outside of the area serviced by the network of doctors and medical service providers, you can still join the RHP, and be eligible for benefits of the Traditional Plan component, and you will have the freedom to select any doctor. Preventive care/annual exams are covered in full. For all other covered services, the employee’s cost share is a copayment or coinsurance after they have met their required deductible.

All offered CDPHP Medical Plans include Prescription coverage administered by CVS Caremark. Covered members can access prescription benefit information via their CDPHP account online.

The tiered format places drugs into tiers in the following manner:

  • Tier 1: Preferred Generics
  • Tier 2: Preferred brands, non-preferred generics
  • Tier 3: Non-preferred brands, select non-preferred generics
  • Tier 4: Preferred Specialty
  • Tier 5: Non-preferred specialty

To find a specific medication visit CDPHP's Formulary 5 then view your plan Benefit Summary above or our Benefits Guide for the cost. 

Prescription coverage also includes:

  • CVS 90: mail order program offering a 90 day supply for two copays
  • Rx for Less is a program for all CDPHP members, offering deep discounts on a specific list of drugs when purchased at Price Chopper, CVS, Walmart, Hannaford, or ShopRite. Many generic prescription drugs are available for as little as $1.

Faculty and Staff of Rensselaer at Hartford can elect medical coverage with Anthem BlueCross BlueShield. This plan offers in and out of network coverage, access to enhanced virtual care and prescription benefits.

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