Product for all clients joining after December 15, 2014
This is a tool designed to assist you in anticipating your potential member's drugs costs. Each membership has specific drug benefit and a specific drug pricing tool. When you need to determine a cost for a medication, you need to select the appropriate drug pricing tool by matching the drug benefit and calendar year maximum with the drug pricing tool listed below.
Level 1
Outpatient Prescription Drug Benefit-Up to a Generic Drug Prescription maximum of $5, Up to a Brand Drug maximum of $15. The benefit pays up to a Membership Year Maximum of $300.
Level 2
Outpatient Prescription Drug Benefit-Up to a Generic Drug Prescription maximum of $10, Up to a Brand Drug maximum of $25. The benefit pays up to a Membership Year Maximum of $500.
Level 3
Outpatient Prescription Drug Benefit-Up to a Generic Drug Prescription maximum of $10, Up to a Brand Drug maximum of $25. The benefit pays up to a Membership Year Maximum of $600.
Level 4
Outpatient Prescription Drug Benefit-Up to a Generic Drug Prescription maximum of $10, Up to a Brand Drug maximum of $25. The benefit pays up to a Membership Year Maximum of $700.
Level 5
Outpatient Prescription Drug Benefit-Up to a Generic Drug Prescription maximum of $10, Up to a Brand Drug maximum of $25. The benefit pays up to a Membership Year Maximum of $800.
Level 6
Outpatient Prescription Drug Benefit-Up to a Generic Drug Prescription maximum of $10, Up to a Brand Drug maximum of $25. The benefit pays up to a Membership Year Maximum of $900.
Level 7
Outpatient Prescription Drug Benefit-Up to a Generic Drug Prescription maximum of $10, Up to a Brand Drug maximum of $25. The benefit pays up to a Membership Year Maximum of $1,000.