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.
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90-Day Maintenance Copay |
90-Day Maintenance Coinsurance |
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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 |