Getting the Most from Your Pharmacy Benefits We know you are concerned about the cost of medications. Prevea360 Health Plan has created a package of pharmacy benefits that provides convenience and increases access to more medications at lower costs.
90-day Generic Maintenance Drug Program† By providing 90-day supplies of maintenance drugs, you’re spending less and getting more of the medication you need. Member cost share for 90-day fills*: • 2 times your copay for all tier 1 and tier 2 medications through a mail-order pharmacy • 2.5 times your copay for tier 1 and tier 2 generic maintenance medications at retail pharmacies
Expanded Preventive Drug List† Now more medications are covered at $0 for large group members which helps you manage drug costs. New drugs added to the Preventive Drug List include: • Preferred mental health medications • Preferred brand diabetes medications • Preferred Insulin • Preferred inhalers and nebulizer solutions To see the most up-to-date list of $0 preventive drugs*, visit prevea360.com/pharmacybenefits or check out the Member Document Center on prevea360.com Generic Medications Generic medications have the same active ingredients as brand-name medications. They are safe and effective but are far less expensive. Your pharmacist can find available manufacturer coupon programs for high-cost specialty drugs or your doctor may be able to recommend a generic at a lower cost.
• Tier 3 at 3 times your copay (both mail-order and retail) • Tier 4 is not eligible for a 90-day supply
$0 Preferred Diabetic Supplies ** Cost should not be a barrier to controlling your diabetes. That’s why all formularies will include preferred diabetic supplies such as syringes, lancets, and pen needles at $0 for large and small group members. This way you can focus on staying healthy, not the cost of getting there.
$35 Cost-Sharing Cap on Preferred Insulin††
† Benefits are available only for large group (51+ employees) plans. †† B enefit available for ACA-compliant small group plans. All ACA-compliant small group members, including High Deductible Health Plans (HDHP), will not pay more than $35 a month for preferred insulin. * Members with tier 1 or tier 2 pharmacy benefits with coinsurance will still be charged the full coinsurance amount. ** B enefit is available for both large group (51+ employees) plans and ACA-compliant small group (2 - 50 employees) plans.
Lower costs on the diabetic medication you need. Access your formulary for the most up-to-date listing of insulins.
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| 2023 Group Insurance Plans
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