Your Prescription Plan

All of the medical plan options include prescription drug coverage which is provided through CVS/Caremark, Inc.  With this plan, you can receive periodic prescriptions through your local retail pharmacy for up to three refills.  For maintenance prescriptions (prescriptions are taken on a regular basis for an extended period of time), you will need to fill the prescription at a CVS/Caremark pharmacy or use the CVS/Caremark mail order option.  Mail order forms can be found in the HR Forms Library or by visiting http://www.caremark.com.

 

 

PRESCRIPTION CO-INSURANCE COSTS AT A GLANCE

 

PRESCRIPTIONS FOR 85/60 PLANS

  • 10% with an $80 maximum for each generic prescription
  • 20% with an $80 maximum for each brand name prescription
  • 40% with an $80 maximum for each brand name prescription when a generic is available.
  • NOTE:  Exception to the $80 maximum is when a brand name medication prescribed when a generic is available, the maximum co-insurance is $100 unless your physician specifies Dispensed as Written (DAW).

PRESCRIPTIONS FOR HDHP PLANS

Your HDHP requires you to pay the full negotiated cost for your care until you reach your deductible for most health care expenses, including most prescription medications. After you meet the deductible, you pay only the coinsurance and your plan pays the rest. If you are enrolled in a HDHP, using medications on the preventive drug list will reduce your cost for select prescriptions that help prevent chronic health conditions when taken regularly. If you take medications on the preventive drug list, you will pay only the copay or coinsurance for these medications even if you have not yet met your annual plan deductible.

  • NOTE: During the initial deductible phase, prescriptions will be 100% of the negotiated price to the member until the deductible is met.  Once the deductible is met, co-insurance prescription costs will be as follows:
  • 10% with a $60 maximum for each generic prescription
  • 20% with a $60 maximum for each brand name prescription
  • 40% with a $60 maximum for each brand name prescription when a generic is available.
  • NOTE:  Exception to the $60 maximum is when a brand name medication prescribed when a generic is available, the maximum co-insurance is $100 unless your physician specifies Dispensed as Written (DAW).

Get More Prescription Details

 

 

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