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)

Mail Order (90 day supply)

Specialty Drugs

(30 day supply) Generic: $10 Copay Preferred Brand: 40% Copay Non-Preferred Brand: 50% Copay

Generic: $20 Copay Preferred Brand: 40% Copay Non-Preferred Brand: 50% Copay

Generic: $10 Copay Preferred Brand: 40% Copay Non-Preferred Brand: 50% Copay

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

Contact Member Services – 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.