Prescription Costs
The cost of prescription medications will depend on the plan an employer offers, as shown in the tables below.
See definitions of the terms used in the tables.
Express Scripts Standard Plan
| Retail | Home Delivery | |
|---|---|---|
|
Generic copayment
|
Up to $10
|
Up to $25
|
|
Preferred Brand-Name
copayment |
Up to $40
|
Up to $100
|
|
Non-preferred Brand-Name and Brand Non-Sedating Antihistamines copayment
|
Up to $80
|
Up to $200
|
|
Dispensing Limits Per
Copayment |
Up to 30-
day supply |
Up to 90-
day supply |
Express Scripts Premium Plan
| Retail | Home Delivery | |
|---|---|---|
|
Generic copayment
|
Up to $5
|
Up to $12
|
|
Preferred Brand-Name
copayment |
Up to $30
|
Up to $75
|
|
Non-preferred Brand-Name and Brand Non-Sedating Antihistamines copayment
|
Up to $60
|
Up to $150
|
|
Dispensing Limits Per
Copayment |
Up to 30-
day supply |
Up to 90-
day supply |
*Deductible is for Brand-Name medications
CDHP/HSA
| |
Retail and Home Delivery Prescription Drugs |
|---|---|
|
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 Preferred and Brand Non-Sedating Antihistamines
|
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.