
Medical Plan
Prescription Drug Coverage
Each medical plan provides prescription drug coverage. The amount you pay depends on the plan you select. Benefit Tip: The Anthem Blue Cross Silver and Bronze plans both provide 100% coverage for preventive medications (most blood pressure medications, for example).
Anthem Blue Cross Gold Plan | Anthem Blue Cross Silver Plan | Anthem Blue Cross Bronze Plan | Kaiser Permanente† | |
---|---|---|---|---|
IN-NETWORK | You Pay | You Pay | You Pay | You Pay |
Pharmacy Retail RX (up to 30-day supply) | ||||
Preventive | N/A | $0 | $0 | N/A |
Generic | $10 | $10 | $10 | $10 |
Preferred Brand | $30 | 20% $25 min**/$50 max. | 20% $25 min**/$50 max. | $35 |
Non-Preferred Brand | $50 | 20%: $50 min.**/$100 max. | 20%: $50 min.**/$100 max. | N/A |
Specialty | $50 | 20%: $75min.**/$200 max. | 20%: $75min.**/$200 max. | N/A |
Mail Order RX (up to 90-day supply) | ||||
Preventive | N/A | $0 | $0 | N/A |
Generic | $20 | $20 | $20 | $20 |
Preferred Brand | $60 | 20%: $65 min.**/$125 max. | 20%: $65 min.**/$125 max. | $70 |
Non-Preferred Brand | $100 | 20%: $125 min.**/$250 max. | 20%: $125 min.**/$250 max. | N/A |
Specialty (30-day supply only) | $50 | 20%: $75 min.**/$200 max. | 20%: $75 min.**/$200 max. | N/A |
*After deductible
**If the actual cost of the drug is less than the minimum, you pay the cost of the drug.
***Defaults to family deductible if you have spouse or family coverage.
†Available to employees in the following states only: California, Colorado, District of Columbia, Georgia, Maryland, Oregon, Virginia and Washington.

Medical Plan
Prescription Drug Coverage
Each medical plan provides prescription drug coverage. The amount you pay depends on the plan you select. Benefit Tip: The Anthem Blue Cross Silver and Bronze plans both provide 100% coverage for preventive medications (most blood pressure medications, for example).
Anthem Blue Cross Gold Plan | Anthem Blue Cross Silver Plan | Anthem Blue Cross Bronze Plan | Kaiser Permanente† | |
---|---|---|---|---|
IN-NETWORK | You Pay | You Pay | You Pay | You Pay |
Pharmacy Retail RX (up to 30-day supply) | ||||
Preventive | N/A | $0 | $0 | N/A |
Generic | $10 | $10 | $10 | $10 |
Preferred Brand | $30 | 20% $25 min**/$50 max. | 20% $25 min**/$50 max. | $35 |
Non-Preferred Brand | $50 | 20%: $50 min.**/$100 max. | 20%: $50 min.**/$100 max. | N/A |
Specialty | $50 | 20%: $75min.**/$200 max. | 20%: $75min.**/$200 max. | N/A |
Mail Order RX (up to 90-day supply) | ||||
Preventive | N/A | $0 | $0 | N/A |
Generic | $20 | $20 | $20 | $20 |
Preferred Brand | $60 | 20%: $65 min.**/$125 max. | 20%: $65 min.**/$125 max. | $70 |
Non-Preferred Brand | $100 | 20%: $125 min.**/$250 max. | 20%: $125 min.**/$250 max. | N/A |
Specialty (30-day supply only) | $50 | 20%: $75 min.**/$200 max. | 20%: $75 min.**/$200 max. | N/A |
*After deductible
**If the actual cost of the drug is less than the minimum, you pay the cost of the drug.
***Defaults to family deductible if you have spouse or family coverage.
†Available to employees in the following states only: California, Colorado, District of Columbia, Georgia, Maryland, Oregon, Virginia and Washington.
Part-time and Temporary employees are eligible for a limited subset of benefits. Union employees: refer to your collective bargaining agreement for your benefits eligibility.