| Medication Category | Cost Per Prescription | |
|---|---|---|
| Up to a 30 Day Supply | Up to a 90 Day Supply | |
| Generics (Preferred and Non-Preferred) | $10 copay | $15 copay |
| Brand Name - Preferred | $30 copay | $45 copay |
| Brand Name - Non-Preferred | $45 copay | $70 copay |
| Lifestyle (e.g. Erectile Dysfunction) | $50 copay | $75 copay |
| Specialty | 25% coinsurance up to $150 | 25% coinsurance up to $225 |
Calendar year out-of-pocket ("OOP") limit for presciptions is $4,600 individual and $9,200 family. Prescription drug copayments/coinsurance are subject to the OOP limit. Once the member and/or family OOP limit is satisfied, no additional copayments/coinsurance are required for the remainder of the calendar year.
Note, certain medications identified under Health Care Reform will be covered 100%; no cost to the member.
For more information, contact MedImpact Member Services 24/7 at 1-888-672-7151.