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Benefit highlights: retail plan

When to Use
The most efficient way to use your retail pharmacy benefit is to present your member ID card at a participating retail pharmacy. Your retail plan should be used for medications required on a short-term basis. When you have a prescription filled at a participating pharmacy, present your member ID card to the pharmacist, who will use an automated system to verify your coverage and prescription cost.

Days Supply
At retail pharmacies, you may purchase up to a 31-day supply of most prescription medications. There may be limitations on some prescriptions, such as controlled medications, subject to state and federal dispensing limitations.

Co-payment
Different co-payments may apply for certain medications.

Tier 1:
  • Your co-payment is $10.00.

Tier 2:
  • Your co-payment is $25.00.

Tier 3:
  • Your co-payment is $50.00.

If the patient requests a brand-name medication when a generic equivalent is available, your co-payment will be equal to the generic co-payment plus the difference in price between the brand-name medication and its generic equivalent. This difference in price is charged only on certain medications.

Click here to determine pricing and coverage for a specific medication.

This information is intended to serve as a general overview of your plan sponsor's prescription benefit program. Please note that the terms of your prescription benefit are subject to change. Please consult your plan sponsor for complete information.
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