Select
I want full coverage with lots of benefits.
Classic
I need affordable protection, in case something serious happens.
Savvy100
I want more control and flexibility, plus potential tax savings.
ShortTerm
I need temporary coverage while I’m in transition.
COMPARE PLANSPrescription Drug Benefits
Prescription drug benefits provide cost-effective coverage and value with your safety in mind. If the Individual Plan you select covers prescription drugs, generally the benefits provide for:
- Generic and brand-name drugs listed on our Preferred Drug List*(also called a formulary)- Your out-of-pocket expenses are lowest when you fill prescriptions for generic and preferred brand-name drugs.
- Non-preferred drugs (also called a formulary)- Your copayments are highest for non-preferred drugs.
- Certain specialty pharmaceuticals
Our Mail Service Pharmacy Benefit can save you time and money – If you have a pharmacy benefit with your Individual Plan, you may be able to enjoy the convenience and savings of our mail service pharmacy.
Once you enroll, your member materials will provide more information about all prescription drug benefits.
For more information, click here.
Three Prescription Benefit Options for Select and Classic Plans1,2
| Option 1 (Standard) | Option 2 (Generic Only) | Option 3 | |
|---|---|---|---|
| Generic Only | Not Covered | $0 | Not Covered |
| Generic (Preferred) | $10 | $10 | Not Covered |
| Brand (Preferred) | $35 | Not Covered | Not Covered |
| Non-Preferred | $75 | Not Covered | Not Covered |
1Benefit Certification may be required. 2Not subject to Deductible.
Note: For the Classic plan, Brand Preferred and Non-Preferred drugs are subject to an additional $250 deductible.
Two Prescription Benefit Options for Savvy100 Plans1
| Option 1 | Option 2 | |
|---|---|---|
| Generic (Preferred) | $0 | Not Covered |
| Brand (Preferred) | $0 | Not Covered |
| Non-Preferred | $0 | Not Covered |
1Benefit Certification may be required.
*Presbyterian’s Preferred Drug List
The Preferred Drug List is continually revised and updated by a committee of practitioners and pharmacists. The committee uses specific criteria to adopt procedures about managing pharmaceuticals and to make decisions about adding new drugs to the list. You can find the Preferred Drug list on our website. If you need a drug that is not on the preferred drug list, your practitioner can request an exception. We will look at the request and give authorization if we find that the drug is medically necessary.
