All of the medical plans include prescription drug coverage. Prescription Drug Coverage 12 Save Money with Mail Service for Long-term Medications You can take advantage of mail service rates for a 90-day supply of medicines you take on a regular basis for chronic conditions such as high blood pressure, asthma, diabetes or high cholesterol. Prescription Drugs with a HealthComp Plan EPO 500, PPO 1500, EPO 2000, EPO Copay 5000, PPO 5000 When you enroll in a medical plan administered by HealthComp, you automatically receive prescription drug coverage through CerpassRx. The CerpassRx pharmacy network includes all national chains and most local pharmacies. The PPO 1500 and PPO 5000 plans also have out-of-network coverage, but you will save money if you use participating network pharmacies. Specified Preventive Drugs: Certain generic preventive medications (like birth control) are covered at no cost and not subject to annual deductibles provided certain requirements are met. Generic Drugs: Generic drugs have the lowest copays and are considered identical to their brand name equivalents by the FDA in terms of efficacy and safety. Brand Formulary: Drugs on the brand formulary are designated as preferred based on their cost effectiveness and, in some cases, efficacy. If you or your provider choose a brand formulary medication when a generic is available, you’ll pay the brand formulary copay plus the difference in cost between the generic and the brand formulary drug. Brand Non-Formulary: Brand name drugs not on the brand formulary have the highest copays. When you fill a prescription, you can ask the pharmacist whether a generic or brand formulary drug of your medication is available. If you or your provider choose a brand non-formulary medication when a generic is available, you’ll pay the brand non-formulary copay plus the difference in cost between the generic and the brand non-formulary drug. Specialty Drugs: These are high-cost drugs that typically require special handling or administration. You must obtain specialty drugs through a CerpassRx Specialty pharmacy. Prescription Drugs with the Kaiser CA HMO 2000 When you enroll in the Kaiser CA HMO 2000, you automatically receive prescription drug coverage through Kaiser. Many Kaiser Permanente facilities have pharmacies in the building, so you can go there straight after your appointment. You can refill prescriptions in person, online or by phone. Refill in person: Bring your prescription to a Kaiser pharmacy. Online: Visit kp.org/rxrefill to order your prescription refills online. You will need to register first at kp.org/registernow. Phone: Call the pharmacy refill phone number highlighted on your prescription label. Have your medical record number, prescription number, home telephone number, and credit or debit card information handy when you call. Prescription Drugs with the SIMNSA Baja CA Premier Access HMO When you enroll in the SIMNSA Baja CA Premier Access HMO, you automatically receive prescription drug coverage through SIMNSA Health Plan. Visit the SIMNSA website at www.simnsa.com for a list of network pharmacies you can use.
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