What is the maintenance tier?

There are lower copays and coinsurance on a large group of maintenance drugs from the special, less costly 90-day network. To utilize the maintenance tier and to receive the lower cost associated with it, you must fill a 90-day supply either through a 90-day network pharmacy or via mail order. These medications include:

  • Oral diabetic medications, insulin and supplies (test strips, lancets & needles)
  • Statins (cholesterol-lowering drugs)
  • Antihypertensives (blood pressure medications)
  • Depression
  • Asthma
  • Chronic Obstructive Pulmonary Disease (COPD)
  • Coronary Artery Disease (CAD)
  • Congestive Heart Failure (CHF)

Some of the more common drugs that are eligible for the reduced copay are: Metformin, Glimepiride, Actos, Januvia, Novolog, Simvastatin, Crestor, Atorvastatin, Pravastatin, Lovastatin, Lisinopril, Hydrochlorothiazide, Amlodipine and Atenolol.

 

 

90-Day Maintenance Copay

90-Day Maintenance Coinsurance

Tier

Premier PPO

Standard PPO

Limited PPO

Local CDHP/HSA (local ed and local gov only)

CDHP/HSA

Generic

$7

$14

$14

20% w/o first having to meet deductible

10% w/o first having to meet deductible

Preferred

$40

$50

$60

20% w/o first having to meet deductible

10% w/o first having to meet deductible

Non-Preferred

$160

$180

$200

20% w/o first having to meet deductible

10% w/o first having to meet deductible

Have more questions? Submit a request