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Fixed Co-Pay $10/$50/$75 Rx

Up to 30-day prescription drug supplies are available through participating retail pharmacies. Present your ID Card along with your doctor’s written prescription to the pharmacist. The pharmacist will charge you a $10.00 co-payment for each preferred generic prescription drug purchased a $50.00 co-payment for each preferred brand name drug purchased, and a $75.00 co-payment for each non-preferred drug purchased. 31-90 day supplies are available through the mail order service at 2 times the applicable co-payment amount.

Unless prohibited by your physician, all plans require mandatory generic drug substitution when a generic drug is available. Anyone using maintenance medications should take advantage of the Mail Order Prescription Service. You can purchase up to a 90-day supply of a medication by mail. This eliminates the need to make repeated visits to the pharmacy and provides you with additional cost and timesaving.

For complete information & verification of all your benefits, refer to your benefits certificate. In the event a conflict exists between the information contained on this benefit description and the actual terms of the group contract, the terms of the contract will prevail. For further information, please call Customer Service at (973) 379-1090.

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