
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). Click here for a list of preventive medications.
Anthem Blue Cross Gold Plan | Anthem Blue Cross Silver Plan | Anthem Blue Cross Bronze Plan | Kaiser Permanente† | |
---|---|---|---|---|
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 - Non PrudentRX | $50 | 20%*: $75 min.**/$200 max. | 30%*: $75 min.**/$200 max. | N/A |
Specialty - PrudentRX | $0 cost of share to member if enrolled. If not enrolled 30% coinsurance‡ | 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 - Non PrudentRX | $50 | 20%*: $75 min.**/$200 max. | 30%*: $75 min.**/$200 max. | N/A |
Specialty - PrudentRX | $0 cost of share to member if enrolled. If not enrolled 30% coinsurance‡ | 20%*: $75 min.**/$200 max. | 30%*: $75 min.**/$200 max. | N/A |
**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.
‡ The PrudentRx Copay Program allows you to get any of your covered specialty medications that are on your Plan's Exclusive Specialty Drug list for $0 out-of-pocket when you fill at CVS Specialty. Must be enrolled. Call PrudentRx 800-578-4403.