Prescription Drug Coverage

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.	30%: $25 min.*/$50 max.	$35
Non-Preferred Brand	$50	20%: $50 min.*/$100 max.	30%: $50 min.*/$100 max.	N/A
Specialty	$50	20%: $75 min.*/$200 max.	30%: $75 min.*/$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.	30%: $65 min.*/$125 max.	$70
Non-Preferred Brand	$100	20%: $125 min.*/$250 max.	30%: $125 min.*/$250 max.	N/A
Specialty (30-day supply only)	$50	20%: $75 min.*/$200 max.	30%: $75 min.*/$200 max.	N/A

*Copay/cost share applies after plan deductible is met.
**If the actual cost of the drug is less than the minimum, you pay the cost of the drug.
†Available to employees in the following states only: California, Colorado, Mid Atlantic, Georgia, Northwest and Washington.

Medical Plan