Prescription Costs
HealthChoice Medication supply information for active and pre-Medicare
| Prescription Medications | 30-Day Supply | 90-Day Supply |
|---|---|---|
| Generic | Up to $10. |
Up to $25. |
| Preferred | Up to $45. |
Up to $90. |
Non-Preferred |
Up to $75. |
Up to $150. |
| Specialty | Generic – $10 copay. Preferred – $100 copay. Non-Preferred – $200 copay. |
30-day copays apply to each additional 30-day supply. |
| Insulin Effective Nov. 1, 2021, for ALL health insurance plans. |
No more than $30. | No more than $90. |
| HealthChoice High*, High Alternative*, Basic*, Basic Alternative* and HDHP** Plans The applicable pharmacy deductible must be met before pharmacy copays apply. Refer to the bottom of the page for more details. Note: Only FDA approved drugs and drugs with FDA Emergency Use Authorizations are covered. Experimental treatments and unapproved drugs and drugs not approved or not authorized for emergency use by the FDA are not covered under this plan. |
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Pharmacy deductible
*HealthChoice High, High Alternative, Basic and Basic Alternative plan members must meet the pharmacy deductible of $100 per individual/$300 maximum per family before benefits are available.
**HDHP members must meet the combined medical and pharmacy deductible ($1,750 individual/$3,500 family) before benefits are available.
Medications on the HealthChoice Preventive Medication List are not subject to the deductible. Copays apply to the pharmacy out-of-pocket maximum, but not the deductible.
For questions regarding the benefits under the pharmacy plan, please contact the pharmacy benefit manager toll-free at 877-720-9375, 24 hours seven days a week. TTY users call 711.
The links below allow you to estimate the amount you will pay for your medications under the different HealthChoice plans. The estimates use pricing data currently available from pharmacies. Please note that prices can vary between both pharmacies and pharmaceutical manufacturers. The prices shown are estimates and are not guaranteed. The links below open in a new window.
- High and High alternative plans
High and High Alternative Plans- HealthChoice High, High Alternative plan members must meet the pharmacy deductible of $100 per individual/$300 maximum per family before benefits are available.
- Basic and Basic alternative plans
Basic and Basic Alternative Plans- HealthChoice Basic and Basic Alternative plan members must meet the pharmacy deductible of $100 per individual/$300 maximum per family before benefits are available.
- High Deductible Health Plan
High Deductible Health Plan- HDHP members must meet the combined medical and pharmacy deductible ($1,750 individual/$3,500 family) before benefits are available.
- Pharmacy locator
With this link, you can find a network pharmacy convenient to your location. This site provides all available network pharmacies via the CVS/caremark site.
