I checked the drug list and I meet all the step requirements for my expensive medication. That said, it’s unclear if the cost of the drug will count toward the out of pocket max. Details below. I appreciate the help in advance!
For generic the plan states $15 copay/prescription for retail 30-day supply. Deductible does not apply.
Preferred brand-name drugs the plan states 20% coinsurance with $35 min with $65 max for retail 30-day supply, $85 copay/for 90 day supply. Deductible does not apply.
Non-Preferred brand-name drugs the plan states 40% coinsurance with $55 min, with $100 max for retail 30-day supply, $125 copay/prescription for 90-day supply. Deductible does not apply.
Specialty Drugs the plan states 20% coinsurance with $300 maximum for retail or mail order 30 day supply; Deductible does not apply.
I would be in the specialty category and am just trying to estimate my annual cost. Let me know if you need more info.
submitted by /u/DC_Schemin
[link] [comments]
I checked the drug list and I meet all the step requirements for my expensive medication. That said, it’s unclear if the cost of the drug will count toward the out of pocket max. Details below. I appreciate the help in advance! For generic the plan states $15 copay/prescription for retail 30-day supply. Deductible does not apply. Preferred brand-name drugs the plan states 20% coinsurance with $35 min with $65 max for retail 30-day supply, $85 copay/for 90 day supply. Deductible does not apply. Non-Preferred brand-name drugs the plan states 40% coinsurance with $55 min, with $100 max for retail 30-day supply, $125 copay/prescription for 90-day supply. Deductible does not apply. Specialty Drugs the plan states 20% coinsurance with $300 maximum for retail or mail order 30 day supply; Deductible does not apply. I would be in the specialty category and am just trying to estimate my annual cost. Let me know if you need more info.
submitted by /u/DC_Schemin [link] [comments]Read Morer/HealthInsurance