Pharmacy benefits are included when you and your dependents enroll in a health plan. The plan you choose determines the out-of-pocket prescription costs. How much you pay for your drug depends on whether it is a generic, brand or non-preferred brand and the day-supply.
| Pharmacy* (in-network) | Premier PPO | Standard PPO | CDHP/HSA |
|---|---|---|---|
| Generic | $7 | $14 | 20% coinsurance after deductible is met |
| Brand | $40 | $50 | 20% coinsurance after deductible is met |
| Non-preferred brand | $90 | $100 | 20% coinsurance after deductible is met |
| Pharmacy* (in-network) | Premier PPO | Standard PPO | CDHP/HSA |
|---|---|---|---|
| Generic | $14 | $28 | 20% coinsurance after deductible is met |
| Brand | $80 | $100 | 20% coinsurance after deductible is met |
| Non-preferred brand | $180 | $200 | 20% coinsurance after deductible is met |
| Pharmacy* (in-network) | Premier PPO | Standard PPO | CDHP/HSA |
|---|---|---|---|
| Generic | $7 | $14 | 10% coinsurance without having to meet deductible |
| Brand | $40 | $50 | 10% coinsurance without having to meet deductible |
| Non-preferred brand | $160 | $180 | 10% coinsurance without having to meet deductible |
| Pharmacy* (in-network) | Premier PPO | Standard PPO | CDHP/HSA |
|---|---|---|---|
| Coinsurance | 10% (min $50; max $150) |
10% (min $50; max $150) |
20% after deductible |
*These are the in-network pharmacy benefits. If out of network pharmacy benefits are available, they are di erent and will cost you more.
**Specialty Pharmacy Tier: Specialty drugs must be filled through a Specialty Network Pharmacy and can only be filled every 30 days.
Did you know CVS/Caremark has website tools to help you compare costs for your prescriptions? You also can find out what you have spent in the past. To learn more, go to caremark.com/wps/portal. You must register to view your prescription history and costs.
Tags: Pharmacy
