Compare prescription drug costs
The amount you pay for prescription drugs depends on which medical plan you choose. There is no coverage for out-of-network prescription drug costs.
Note about the Consumer Plan: You pay all your expenses up front—including prescriptions—until you reach the full deductible ($1,850 for associate only coverage and $3,700 for family coverage). After that, you pay a percentage of the cost of prescription drugs up to the out-of-pocket maximum.
In-network costs
| Traditional Plan | Protection Plan | Consumer Plan | Surest Plan | |
| Out-of-pocket maximum | $3,000/person $6,000/family |
$3,000/person $6,000/family |
Does not apply. Prescriptions included in medical maximum. |
$3,000/person $6,000/family |
| Retail Prescriptions | ||||
| Generic, 30-day supply | $10 copay | $10 copay | Associate pays 30% after deductible | $10 copay |
| Brand Formulary, 30-day supply | Associate pays 30% ($30 min, $80 max) |
Associate pays 30% ($30 min, $80 max) |
Associate pays 30% after deductible |
Associate pays 30% ($30 min, $80 max) |
| Generic, 90-day supply | $30 copay | $30 copay | Associate pays 30% after deductible |
$30 copay |
| Brand Formulary, 90-day supply | Associate pays 30% ($90 min, $240 max) |
Associate pays 30% ($90 min, $240 max) |
Associate pays 30% after deductible |
Associate pays 30% ($90 min, $240 max) |
| Mail-order Prescriptions | ||||
| Generic, 90-day supply | $20 copay | $20 copay | Associate pays 30% after deductible |
$20 copay |
| Brand Formulary, 90-day supply | Associate pays 30% ($60 min, $160 max) |
Associate pays 30% ($60 min, $160 max) |
Associate pays 30% after deductible |
Associate pays 30% ($60 min, $160 max) |
| Specialty Prescriptions | ||||
| Generic specialty | $100 copay | $100 copay | Associate pays 30% after deductible |
$100 copay |
| Brand specialty | Associate pays 20% ($500 max per script) | Associate pays 20% ($500 max per script) | Associate pays 30% after deductible |
Associate pays 20% ($500 max per script) |
| Fertility Coverage | Fertility medications covered with a $10,000 lifetime max | Fertility medications covered with a $10,000 lifetime max | Fertility medications covered with a $10,000 lifetime max | Fertility medications covered with a $10,000 lifetime max |
Save money on prescriptions
- Ask your doctor if a generic version of the medicine will work for you.
- Talk with your doctor about using medicines from your plan's formulary (a list of approved drugs).
- Use mail-order for 90-day supplies—it’s not only convenient, but costs less too.
EncircleRx Through Express Scripts
EncircleRx is a weight management program that includes coverage for select prescription weight management medications. This program requires participation in the Omada online lifestyle modification program that partners with ExpressScripts. EncircleRX FAQ, Omada program flyer.