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Saving on Prescriptions

Understand your options to save on your prescriptions and stay well

CVS Caremark Prescription Coverage

When you enroll in an Anthem healthcare plan, you are automatically enrolled in the prescription drug benefit through CVS Caremark. Your formulary offers a wide selection of clinically sound, cost-effective generic, and brand-name prescription drugs. Additionally, CVS Caremark offers many convenient and affordable options to fill your prescriptions, such as retail pharmacies, mail-order, and specialty orders. The plan includes several utilization management programs to promote safety along with appropriate and cost-effective use of prescription medications. Your cost to fill a prescription depends on the healthcare plan you are enrolled, as well as, the drug tier. 

Need more information? If you need help understanding your pharmacy benefit, terms or costs/discounts, side effects, and alternatives, talk to your Accolade Health Assistant. They can help you understand how to get the most out of your pharmacy benefit. Visit member.accolade.com or call 866-204-9818.

  • Consumer Choice HSA

    2022 Consumer Choice HSA Prescriptions

    Annual out-of-pocket maximumCombined with healthcare annual out-of-pocket maximum. See Healthcare Coverage Options
    Preventive medicationTo promote good health and help prevent the need for costly care, the plan offers coverage for a number of preventive medications at $0 copayment and other preventive medications you can receive prior to meeting your deductible.  
    Retail (30-day supply)

    You Pay

    Generic: 20% 

    Preferred brand: 20% 

    Non-preferred brand: 20%

    Mail order (90-day supply)

    You Pay

    Generic: 20% 

    Preferred brand: 20% 

    Non-preferred brand: 20%

    Specialty 

    You Pay

    Generic: 20% 

    Preferred brand: 20% 

    Non-preferred brand: 20%

    30 day limit for new specialty prescriptions

    You can find the list of generic, preferred,  nonpreferred drugs and specialty limits by visiting the CVS Microsite. Some medications may require prior authorization, may have quantity limits, change tiers, or be removed from the list of covered drugs known as the formulary. It is a good idea to periodically review your medications against the current formulary. 

  • Comprehensive Care

    2022 Comprehensive Care Prescriptions

    Annual out-of-pocket maximum 

    Separate from healthcare annual out-of-pocket maximum. 

    Individual: $1,500

    Employee + 1: $3,000

    Employee + 2 or more: $4,500

    Preventive medicationTo promote good health and help prevent the need for costly care, the plan offers coverage for a number of preventive medications at $0 copayment. 
    Retail (30-day supply)

    You Pay

    Generic: $15 copay

    Preferred brand: 20%; $40 minimum, $100 maximum

    Non-preferred brand: 35%; $100 minimum, $200 maximum

    Mail order (90-day supply)

    You Pay

    Generic: $45 copay

    Preferred brand: 20%; $120 minimum, $300 maximum

    Non-preferred brand: 35%; $300 minimum, $600 maximum

    Specialty 

    You Pay

    Generic: 20%;  $75 maximum

    Preferred brand: 20%; $150 maximum 

    Non-preferred brand: 35%; $200 maximum

    30 day limit for new specialty prescriptions

    Employees approved for greater than a 30-day supply will pay 2x - 3x the applicable 30-day cost. 

    You can find the list of generic, preferred,  nonpreferred drugs and specialty limits by visiting the CVS Microsite. Some medications may require prior authorization, may have quantity limits, change tiers, or be removed from the list of covered drugs known as the formulary. It is a good idea to periodically review your medications against the current formulary. 

  • Blue Choice HMO

    2022 Blue Choice HMO Prescriptions

    Annual out-of-pocket maximum 

    Separate from healthcare annual out-of-pocket maximum. 

    Individual: $1,500

    Employee + 1: $3,000

    Employee + 2 or more: $4,500

    Preventive medicationTo promote good health and help prevent the need for costly care, the plan offers coverage for a number of preventive medications at $0 copayment. 
    Retail (30-day supply)

    You Pay

    Generic:  $15 copay

    Preferred brand: 20%; $40 minimum, $100 maximum

    Non-preferred brand: 35%; $100 minimum, $200 maximum*

    Mail order (90-day supply)

    You Pay 

    Generic: $45 copay

    Preferred brand: 20%; $120 minimum, $300 maximum

    Non-preferred brand: 35%; $300 minimum, $600 maximum*

    Specialty 

    You Pay

    Generic: 20%;  $75 maximum

    Preferred brand: 20%; $150 maximum 

    Non-preferred brand: 35%; $200 maximum

    30 day limit for new specialty prescriptions

    Employees approved for greater than a 30-day supply will pay 2x - 3x the applicable 30-day cost.

    You can find the list of generic, preferred,  nonpreferred drugs and specialty limits by visiting the CVS Microsite. Some medications may require prior authorization, may have quantity limits, change tiers, or be removed from the list of covered drugs known as the formulary. It is a good idea to periodically review your medications against the current formulary. 

Generic and Brand-Name Drugs

If your doctor prescribes a brand-name drug when equivalent generic drugs are available, you will automatically receive an FDA-approved generic drug unless:

  • Your doctor writes “dispense as written” (DAW) on the prescription; or
  • You request the brand-name drug at the time you fill your prescription.

If you are taking a non-generic drug, talk to your doctor to determine if switching to a lower-cost generic medication may be an option for you. If you are taking ongoing maintenance medication, save time by getting your prescriptions conveniently delivered to you.

Kaiser Permanente Prescription Coverage

At most facilities, you can get your prescriptions filled on your way out the door. 

  • Kaiser Permanente HMO

    2022 Kaiser Permanente HMO Pharmacy 

    Annual out-of-pocket maximum $1,500 
    Preventive medicationTo promote good health and help prevent the need for costly care, the plan offers coverage for a number of preventive medications at $0 copayment. 

    Retail (30-day supply)

    At Kaiser Permanente pharmacies

    You Pay

    Generic: $15 copay

    Preferred brand: $45 copay

    Non-preferred brand: $65 copay

    Specialty:  20%; $200 maximum

    Mail order (90-day supply)

    You Pay

    3 x the applicable retail copay per 90-day supply

    If you have questions or would like a copy of the USG preferred drug list, call 404-261-2590 or log into your KP Account.