Let’s make this less confusing…
For non-preventive or specialty drugs you pay the full cost of the medication until you meet the medical deductible ($1500 for an HSA or $1600 for an HRA). Once the deductible is met, you pay a coinsurance and the balance is covered by Express Scripts, your prescription drug provider.
Let’s look at an example. If you’ve been prescribed Humira® for arthritis pain, a 90-day prescription can cost approximately $600, if no generics are available. If you haven’t met your medical deductible, you will have to pay the full $600 (which is applied to your deductible). If you have met your deductible, then your cost-sharing would be less, as your coverage with CVS Caremark will kick in and pay for the majority of the medication.
Quick Tip: Remember, ask your doctor for generics whenever they are available — you will pay much less than brand medication. For more cost-saving tips, click here.
View the 2017 Preferred Drug list.
View the 2018 Preferred Drug list.
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