Prescriptions: Your Costs
Your medical plan provides prescription drug benefits.
Keep in mind that there are different tiers of prescription drugs which have different copays after the deductible. Speak with your doctor about the most effective and cost efficient prescription options.
Note: Under the Premera Blue Cross PPO Medical plan, prescriptions must be filled at a pharmacy that participates in the plan’s network. Otherwise, they will not be covered.
Prescription Benefits
| Premera Blue Cross HDHP |
Premera Blue Cross PPO Medical | |||
|---|---|---|---|---|
| In-Network | Out-of-Network | In-Network | Out-of-Network | |
| 30-day supply (retail pharmacy) | ||||
| Generic | You pay 20% after deductible | You pay 50% after deductible | You pay $5 copay | Not covered |
| Preferred Brand | You pay 20% after deductible | You pay 50% after deductible | You pay $20 copay | Not covered |
| Non-Preferred Brand | You pay 20% after deductible | You pay 50% after deductible | You pay $40 copay | Not covered |
| 90-day supply (mail order) | ||||
| Generic | You pay 20% after deductible | Not covered | You pay $5 copay | Not covered |
| Preferred Brand | You pay 20% after deductible | Not covered | You pay $20 copay | Not covered |
| Non-Preferred Brand | You pay 20% after deductible | Not covered | You pay $40 copay | Not covered |