See the Prescription BenefitTab.
You must use a generic drug substitute whenever it is available. If you or your doctor requests a brand-name drug instead of a generic equivalent, you will be charged the difference in cost between the brand-name drug and the generic, in addition to the co-payment applicable to the quantity and type of drug prescribed. The co-payments, which vary depending on the type of drug prescribed and the quantity dispensed, are detailed below:
Retail Pharmacy; Tier 1 (except Kaiser, Tier 1 represents mostly generic drugs and some brand name drugs) |
$10 up to a 30-day supply |
$10* up to a 30-day supply 1 |
$10 up to a 30-day supply for generic drugs |
$10 up to a 31-day supply |
Retail Pharmacy; Tier 2 (except Kaiser, Tier 2 represents mostly brand drugs and some generic name drugs) |
$20 up to a 30-day supply |
$20* up to a 30-day supply 1 |
$30 up to a 30-day supply for brand name drugs |
$30 up to a 31-day supply |
Mail Order; Tier 1 (except Kaiser, mostly generic drugs and some brand name drugs) |
$20 up to a 90-day supply |
N/A |
$20 up to a 100-day supply for generic drugs |
$20 up to a 90-day supply |
Mail Order; Tier 2 (except Kaiser, mostly brand drugs and some generic name drugs) |
$40 up to a 90-day supply |
N/A |
$60 up to a 100-day supply for brand name drugs |
$60 up to a 90-day supply |
Early retirees please refer to the prescription benefits described under the Retiree Benefit tabs.