Prescription Medications  ($310 deductible)

Initial Coverage

• After you pay your yearly deductible, you pay 25% until total yearly drug costs (paid by member and the plan) reach $2,830.

Coverage Gap

• After total yearly drug costs (paid by member and the plan) reach $2,830, you pay 100% until your yearly out-of-pocket drug costs reach $4,550.

Catastrophic Coverage

• After your yearly out-of-pocket drug costs reach $4,550, you pay the greater of a $2.50 co-pay for generic (including brand drugs treated as generic) and a $6.30 co-pay for all other drugs, or 5% co-insurance.