Prescription Plan
All medical plan participants have prescription drug coverage based on their selected plan. A way to save money is by requesting generics and/or mail order options when available.
Prescription drug benefits are administered by Anthem. Enrollment is automatic for employees and their covered dependents who have elected medical coverage. Prescription coverage varies based on the medical plan you choose. The plan offers coverage for short-term medications (30-day or less) through most retail pharmacies and provides coverage for longer-term maintenance medications (90-day supply) through mail order or pharmacy locations.
| Medical PPO All Employees | In-Network | Out-of-Network |
|---|---|---|
Prescription Drugs (Retail)
|
$15 copay $40 copay $80 copay 75% Coinsurance 30 days |
50% min $80 50% min $80 50% min $80 50% min $80 30 days |
Prescription Drugs (Mail Order)
|
$15 copay $100 copay $200 copay 75% Coinsurance 90 days |
Not covered Not covered Not covered Not covered N/A |
Above is a brief overview of what you can expect to pay for a prescription drug, depending on which tier it falls on the Anthem Essentials Drug List. To see the list and potential costs, follow these steps:
- Go to www.anthem.com/pharmacy information
- Scroll to Formulary/Drug Lists section in the middle of the page and click on Essential Drug List 4-Tier
- Enter name of drug in search box; click “Search”
If your medication is not on the list, there may be brand alternative, generic equivalent, or over the counter (OTC) option.
Important Maitenance Perscription Drug Information
If you use a Maintenance Prescription Drug, one you take every day, week, or month, effective 7/1/2023 you will be required to order a 90-day supply of the drug through the mail order program or purchase a 90-day supply at CVS Pharmacy. Please see www.anthem.com/pharmacyinformation for more information.
PreventiveRx Drug List Enhanced
Video: Prescription Drug Benefits
