prescription what you pay
What you pay
| Retail pharmacy (30-day supply) | Express Scripts mail order service or Smart90 Walgreens (90-day supply) |
|
|---|---|---|
| Medical plan deductible applies | Yes | |
| Generic | After deducible is met, 20% up to a $20 max | After deductible is met, 20% with a $30 min up to $60 max |
| Preferred brand | After deductible is met, 20% with a $35 min and $100 max | After deductible is met, 20% with a $105 min and $300 max |
| Non-preferred brand | 40% after deductible | |
| Contraceptives — generic | Covered in full | |
| Preventive — generic & preferred | Covered in full on the My Health Savings Plan only | |
To check how your prescriptions will be covered under the Choice HRA and the My HSA Plan, visit the Express Scripts pre-enrollment website.
