Prescription Drugs: Copayments

All prescriptions, whether purchased through mail order or at a retail pharmacy, are subject to a copayment. If your physician prescribes a brand-name drug when a generic equivalent is available, you are responsible for paying the difference between the two prices in addition to the copayment.

 Through the mail-order service, you can obtain up to a 90-day supply of medication at one time for only a 60-day copayment (30-day copayment for generic drugs). 

 Your prescription drug copayments at a glance

Annual Out-of-Pocket Maximum

There is an annual out-of-pocket maximum of $1,320 for individuals and $2,640 per family on a calendar-year basis for covered drugs.

Note: Fertility medications have a 50 percent copayment. Special rules apply to Specialty Medications; see the section on Specialty Medications.

For more information, see the section on Preferred & Non-preferred Drugs.