Pharmacy
When you enroll in Medical coverage, you will also receive prescription benefits. Here you can see the basics but be sure to check the formulary for a full list of the prescriptions that are covered by the plan. Remember, you can always ask your doctor about lower-cost alternatives. Generic drugs tend to be less expensive than brand-name drugs, so keep that in mind when shopping around.
Save on Prescription Drugs
Ask for Generics
Generic and brand-name drugs have the same active ingredients, which means they have the same efficacy for treating your condition. The main difference is the cost to you. Brand-name drugs tend to be more expensive because of the lengthy drug development process. Manufacturers charge more to recoup costs. When a patent expires, other manufacturers can produce the medication, and competition drives the price down.
Home Delivery
Enjoy the convenience and savings of home delivery for medications you take on a regular basis through our mail-order prescription program. The larger 90-day supply is mailed directly to your home — saving you time and money.
Pharmacy Plan Comparison
* After Deductible
Note: For coverage types other than Employee Only, the deductible will automatically default to the family deductible.
** 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.
Out-of-Network Providers
You’re free to fill prescriptions outside the Anthem network, but it’s important to understand how costs work. For out-of-network pharmacy services, you’ll pay a higher deductible and coinsurance, and Anthem only covers part of the bill—the rest is your responsibility. These expenses count toward a separate out-of-network out-of-pocket maximum, which can be much higher than the in-network limit.
Smart step: before filling a prescription, ask about the charges so you know your potential costs up front.