Pharmacy Benefits

You have prescription drug coverage from network pharmacies.

When your doctor orders medication for you, you’ll get the generic form. If there isn’t a generic, you’ll get the brand name.

View our drug list. Preferred Agents are on the left side of the page separated by the Non-Preferred Agents on the right side. The generic names are in lower case letters and are Tier 1 and branded medications are in CAPITAL letters and are Tier 2.  Certain medications may have quantity or age limitations, prior authorization requirements, etc. and the bottom of each page will define those abbreviations.

You may be required to try step therapy. This means you must try certain drugs to treat your medical condition before we’ll cover another drug for that condition. Your provider may submit a medical necessity request form to waive step therapy requirements or quantity limit restrictions. See your member handbook and the drug list for more information.

100-Day Prescription Supply

Your health plan covers a 100-day supply of eligible medications through local pharmacies. With a 100-day supply, you won’t need to get a refill every month. Medications eligible for the 100-day supply option usually require regular, daily use and/or are commonly used to treat chronic or long-term conditions including high blood pressure, heart disease, asthma and diabetes. Providing members with 100-day prescriptions may lead to:

• More consistent medication supplies for a longer period of time
• Fewer trips to the pharmacy, which is especially helpful if transportation is an issue
• Staying on track with prescriptions