Participants in the Base Coverage will be charged the full allowable amount until the applicable deductible is met. Prescription medications are subject to the applicable deductible and the following copayments:
Retail & Specialty Pharmacies
Prescription Drug Type | 1-30 Day Supply | 31-60 Day Supply | 61-90 Day Supply | Home Delivery 90 Day Supply (or less) |
|---|---|---|---|---|
Preferred Generic Drug | $12 | $24 | $36 | $24 |
Non-preferred Generic Drug | $30 | $60 | $90 | $60 |
Preferred Brand Drug* | $45 | $90 | $135 | $90 |
Non-preferred Brand Drug* | $100 | $200 | $300 | $200 |
Specialty Drug | $100 | N/A | N/A | N/A |
**\*Generic mandate applies to brand drugs purchased when a generic is available.** If a participant purchases a covered brand drug for which a generic equivalent is available, the participant will pay the difference in the cost of the brand and the generic drug, plus the applicable brand copayment amount.