Prescription Drugs
Coverage at a Glance
Your coverage and copayments for your prescription medications depend on the medical plan you select. Here is a chart that shows what each medical plan covers along with the copayment.
| Prescription Drugs | Premium PPO Plan | Standard PPO Plan | Consumer Choice PPO Plan | ||||||
Benefits |
Retail (30-Day Supply) |
Retail (90-Day Supply) |
Mail Order (90-Day Supply) |
Retail (30-Day Supply) |
Retail (90-Day Supply) |
Mail Order (90-Day Supply) |
Retail (30-Day Supply) |
Retail (90-Day Supply) |
Mail Order (90-Day Supply) |
Generic Copay |
$10 $35 $60 |
$30 $105 $180 |
$20 $90 $150 |
$10 $35 $60 |
$30 $105 $180 |
$20 $90 $150 |
Subject to Medical Deductible and Coinsurances | ||
Lifestyle Drugs |
100% of Discounted Price |
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Diabetic Supplies |
Diabetic supply kit (swabs, lancets, syringes and strips) are free when ordered with insulin prescription/refill (mail order and retail) |
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Prescription Drug Categories
- Generic Drugs
A generic drug is identical, or bioequivalent to a brand name drug in dosage, safety, strength, quality, performance characteristics and intended use. Although generic drugs are chemically identical to their branded counterparts, they are typically sold at substantial discounts from the branded price.
- Preferred Drugs
These are prescription drugs that have been placed on a list of preferred drugs for a medical plan. The cost for preferred drugs is generally less than non-preferred drugs but higher than a generic drug.
- Non-Preferred Brand Drugs
These are medications that have been patented for name and chemical content. Once the patent expires, generic drugs with a different name but the same chemical make-up usually become available. Non-preferred drugs are all other prescription drugs that are not generic or on the list of Preferred drugs. Usually non-preferred named drugs are the most expensive and/or have a comparable drug that is either generic or on the preferred list
- .Lifestyle Drugs
These are prescription drugs that are not generally considered medically necessary. You will pay the full cost of the prescription after a discount has been applied. Lifestyle drugs are typically drugs that are prescribed for nonmedically necessary uses such as cosmetic Botox® and Propecia® for hair loss.
CVS/Caremark's Specialty Pharmacy
Prescriptions for certain medications (i.e., Specialty Drugs) may be filled through CVS Caremark’s Specialty Pharmacy. Specialty Drugs are typically drugs that must be refrigerated, that have a short shelf-life, are bio-tech drugs, and/or are expensive medications that are not typically stocked by retail pharmacies.