Prescription Costs
The cost of your prescription medication depends on the plan your employer offers. The tables below show the costs for each plan.
See definitions of the terms used in the tables.
Express Scripts Standard Rx Option
|
|
Retail |
Home Delivery |
|---|---|---|
|
Generic |
Up to $10 |
Up to $25 |
|
Preferred brand-name |
25%; up to $40 min / $80 max |
25%; up to $100 min / $200 max |
|
Non-preferred brand-name and brand non-sedating antihistamines |
40%; up to $80 min / $160 max |
40%; up to $200 min / $400 max |
|
Specialty |
40%; up to $100 min / $200 max |
40%; up to $250 min / $500 max |
CDHP/HSA
|
|
Retail and Home Delivery |
|---|---|
|
Annual Prescription Deductible |
Combined with Medical Deductible |
|
Generic |
15% after deductible |
|
Preferred Brand-Name Drugs (designated by Express Scripts) |
25% after deductible |
|
Brand-Name Drugs Not on Express Scripts National Preferred Formulary and Brand Non-Sedating Antihistamines |
50% after deductible |
|
Specialty Rx list |
50% after deductible |
These charts provide a general description and are provided for informational purposes only. They should not be viewed as an offer of coverage. In the event of a conflict between these charts and the official Plan documents, the official Plan documents will govern.
Drug Categories
Generic - medications with the same active ingredients and manufactured according to the same strict federal regulations as their brand-name counterparts.
Brand-Name - a drug patented by the manufacturer and sold by its brand name.
Preferred - generic and brand-name drugs that are preferred by your plan because they help to control rising prescription drug costs.
Non-preferred - generic and brand-name drugs that are not included on your plan's preferred list. They may be covered, but you may be required to pay a higher cost.
Specialty - typically high cost drugs that are injected or infused in the treatment of acute or chronic diseases. Specialty Drugs often require special handling such as temperature-controlled packaging and expedited delivery. Most Specialty Drugs require preauthorization to be considered Medically Necessary.
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