Pharmacy Benefits

Convenient and affordable prescription drug coverage is included with your Medical plan (both the EPO and HDHP options).

• Comprehensive Coverage Tiers

  • Tier 1 (Generic): Lowest copay — encourages use of safe, cost-effective medications.

  • Tier 2 (Preferred Brand): Mid-level copay — brand-name drugs with proven effectiveness.

  • Tier 3 (Non-Preferred Brand): Highest copay — brand-name drugs that have lower-cost alternatives available.

  • Specialty Medications: Limited to a 30-day supply; may require prior authorization.

• Preventive Medications

  • Certain preventive drugs (like statins and contraceptives) are covered at no cost under federal Affordable Care Act (ACA) guidelines.

  • This means $0 copay even if you are on the HDHP and have not met your deductible.

• Mail Order Savings

  • 90-day supplies of maintenance medications are available through the plan’s mail-order pharmacy service at reduced copays.

  • Convenient home delivery with automatic refills helps avoid missed doses.

• Costs to Employees

  • Under the EPO plan, prescriptions are covered immediately with fixed copays for each tier.

  • Under the HDHP plan, you pay full cost until you meet the deductible; then you pay coinsurance (a percentage) until reaching the annual out-of-pocket maximum.

  • After reaching the deductible, you pay only a small portion of the cost and the plan covers the rest.

Tip: Always ask your doctor if a generic or preferred brand is available to lower your out-of-pocket costs.