Challenge 

Prime Therapeutics needed to help health plan members make informed prescription drug coverage decisions during open enrollment. Members arrived with varying health literacy, strong pharmacy preferences, and little understanding of how formulary tiers, prior authorization, or network status would affect their out-of-pocket costs.
Four jobs drove their behavior: project next year's drug costs, understand what changed year-over-year, identify which plan covers their medications, and find in-network pharmacies that work for them. The platform had to serve all four — across multiple employer groups, each with different plan structures and formularies.

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Approach

I was embedded on the Prime core team as Senior UX Consultant, guiding vendor execution team across prototyping and usability testing.
 

The engagement centered on a four-step comparison wizard — Health Insurance → Pharmacies → Prescriptions → Plan Comparison — supporting both authenticated and guest paths, white-labeled per employer group. Key challenges: making compliance-heavy information (formulary tiers, prior auth flags, network warnings) approachable to health-illiterate members without hiding what they needed to make a real decision. Research ran as moderated concept testing across all three sprint cycles.

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Outcomes

All participants said they would use the application again — validation that the core model was sound before final iteration.

Specific findings drove specific changes: plan tabs weren't recognized as clickable; cost figures lacked 30 vs. 90-day context; coverage amounts were ambiguous across individual, spouse, and family tiers. Each produced a direct recommendation — improved hierarchy, prescription-first defaults, tooltip clarity on tier 3 and prior auth.
The "cheapest isn't always best" insight reframed the results hierarchy, surfacing in-network pharmacy access and specialty drug flags alongside raw cost. The guest path was retained as a deliberate first-class experience after research showed members would abandon rather than authenticate during early enrollment exploration.​​

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Growth Opportunity

The comparison tool addressed a point-in-time enrollment decision. The larger opportunity is continuity — carrying the member's pharmacy relationships, medication history, and coverage understanding forward into an ongoing benefits experience rather than resetting it each enrollment cycle. A member who just compared plans shouldn't have to start from scratch next year.