Prescription Plan
When you enroll in a medical plan, you automatically receive prescription drug benefits. Please see the chart below for an overview of the Cigna prescription drug benefits.
| OAP $7,500 (Base) | OAP $2,500 (Buy-up) | HDHP $3,750 w/ HSA | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Prescription Drug Benefits | ||||||||||||
| Benefit | OAP $7,500 (Base) | OAP $2,500 (Buy-up) | HDHP $3,750 | |||||||||
|
Retail Pharmacy (per 30-day supply) Generic Brand Non-Preferred Specialty |
$25 Copay $60 Copay $95 Copay 30% |
$10 Copay $50 Copay $90 Copay 30% |
$10 Copay (AD) $50 Copay (AD) $90 Copay (AD) 30% AD |
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|
Retail and Home Delivery Pharmacy (per 90-day supply) Generic Brand Non-Preferred |
$75 Copay $180 Copay $285 Copay |
$25 Copay $125 Copay $225 Copay |
$25 Copay (AD) $125 Copay (AD) $225 Copay (AD) |
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Video: Prescription Drug Benefits
