For all Summary Benefit Options log into:
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Prescription
Drug Coverage
Covered prescription medications are available at participating pharmacies.
Your copayments for up to a 30-day supply are:
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Tier 1: $10>
Tier 2: $25>
Tier 3: $40These copayment amounts will be shown on your Plan identification (ID) card. Bring
your prescription or refill to a participating pharmacy, along with your ID card, and pay
the applicable copayment.
Harvard Pilgrims mail service prescription drug program (Maintenance
medications ONLY)
If you have a condition (e.g., high blood pressure) that requires maintenance medications,
you can order up to a 90-day supply of these drugs through Harvard Pilgrims mail service
prescription drug program.
Your copayments for a 90-day supply are:
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Tier 1: $20>
Tier 2: $50>
Tier 3: $80cc5055