How Much Will I Pay for Prescription Drugs?

ALERT! When you use network pharmacies, retail or mail-order, you pay based on the drug's allowed amount, a discounted price negotiated for the plan. If you use a non-network pharmacy of any type, the pharmacy may charge more than the allowed amount; you will have to pay this amount, which doesn't count toward your deductible or out-of-pocket limit and is not payable by the plan. NOTE: Prescriptions ordered through foreign mail-order are not covered, even if you send in a claim.

Until you meet your deductible, you will pay the entire cost of your prescription drugs. Any applicable ancillary charge does not apply to your deductible.

Once you have met your deductible for the year, you pay 15% of the drug's cost for covered prescription drugs. You can get up to a 90-day supply for most drugs (except for specialty drugs). For brand-name drugs with a generic equivalent, you will also pay an ancillary charge.

If a prescription drug isn't covered by the plan, it does not count toward either your deductible or your out-of-pocket limit.

Note: You may use your HSA to pay for many drugs not covered by the plan; see Your Health Savings Account for more information.