How are my prescriptions covered?

Your medical plan determines your share

Prescription coverage is included with your medical plan. Costs depend on the medical option and whether the drug is generic, formulary brand or non-formulary brand.

A cost that does not count toward the maximum

Copayments for the difference between a brand-name product and its generic equivalent do not count toward the out-of-pocket maximum.

Check before you fill

1. 1

   Review covered medications in the MyPrime formulary.

2. 2

   Compare local pharmacy prices, generic options and home delivery.

3. 3

   Ask your physician to complete any required prior authorization, step therapy or quantity-limit form.

What the approval terms mean

1. 1

   Prior authorization: certain medications need approval.

2. 2

   Step therapy: another clinically appropriate or lower-cost medication may need to be tried first.

3. 3

   Quantity limit: a dose outside recommendations may require additional explanation.