Pharmacy Benefits Pharmacy Benefits Included in the Medical Plan Prescription drugs are covered within the Medical Plan, Brand-name drugs have a combined annual deductible and out-of-pocket maximum with the medical benefits. The applicable cost share for covered Brand-Name drugs does apply after the deductible has been met. Generic Drugs have a co-pay, deductible is waived. The co-pay applies to the plan’s out-of-pocket match. Select Brand Name and Specialty Drugs must be obtained through the Prescription Drug Plan’s Specialty Pharmacy, or CanaRx if available.
Prescription Drug Card Retail (30-day supply)
Generic: $10 Co-pay Preferred Brand: 40% Co-pay Non-Preferred Brand: 50% Co-pay
Mail Order (90-day supply)
Generic: $20 Co-pay Preferred Brand: 40% Co-pay Non-Preferred Brand: 50% Co-pay
Specialty Drugs (30-day supply)
Generic: $10 Co-pay Preferred Brand: 40% Co-pay Non-Preferred Brand: 50% Co-pay
Diabetes Management Program • Diabetes maintenance medication and supplies paid at 100% for members actively engaged in Disease Management • Plan participants must maintain contact with GPA Care Coach every 3 months • Plan participants declining to participate will receive standard benefits under the Plan To explore or register – 800-843-6705.
Additional Source for Pharmacy CanaRx is a voluntary prescription drug program that is available to eligible team members and their dependents. This benefit provides a great opportunity to save $$ on your regular maintenance medications. All co-pays are waived for this program. CanaRx is an International Mail Order Program.
A complete list of eligible medications and ordering instructions can be found at www.marinemaxmeds.com
18
