Prescriptions

Have questions about your prescription coverage?

Learn about your benefits, costs, formulary lists and any coverage restrictions by contacting your Pharmacy Benefit Manager (PBM) listed below.

If you prefer talking with a HealthEZ representative, call 1-844-839-6740

Filling prescriptions:

MedOne is your pharmacy benefit manager (PBM).

Your pharmacy information is listed on the back of your medical ID card.

Bring your ID card with you when filling all prescriptions to be sure the pharmacy has current coverage information.

How to guide for Mail Order and Member Portal

Member Portal and Mail Order	Provides general directions on how to enroll in Mail Order, and how to use the Member Portal.

Prescription Drug Coverage

	Retail 30 Day Suppy	Mail Order 90 Day Supply
Value Essential Plan
Generic	$10 Copay	$20 Copay
Preferred Brand	100% Copay	100% Copay
Non-Preferred Brand	100% Copay	100% Copay
Specialty	Not Available	Not Available
Deluxe Platinum Plan
Generic	No Charge	No Charge
Preferred Brand	$30 Copay	$75 Copay
Non-Preferred Brand	$60 Copay	$150 Copay
Specialty	Not Available	Not Available
Choice Gold Plan
Generic	$15 Copay	$37.50 Copay
Preferred Brand	$40 Copay	$100 Copay
Non-Preferred Brand	$60 Copay	$150 Copay
Specialty	Not Covered	Not Covered
Basic Gold Plan
Generic	$15 Copay	$37.50 Copay
Preferred Brand	$50 Copay	$125 Copay
Non-Preferred Brand	$100 Copay	$250 Copay
Specialty	Not Covered	Not Covered
Preferred Silver Plan
Generic	$15 Copay	$37.50 Copay
Preferred Brand	$60 Copay	$150 Copay
Non-Preferred Brand	$100 Copay	$250 Copay
Specialty	Not Covered	Not Covered
Enhanced Silver Plan
Generic	$15 Copay	$37.50 Copay
Preferred Brand	$75 Copay	$187.50 Copay
Non-Preferred Brand	$100 Copay	$250 Copay
Specialty	Not Covered	Not Covered
Classic Silver Plan
Generic	$15 Copay	$37.50 Copay
Preferred Brand	$75 Copay	$187.50 Copay
Non-Preferred Brand	$100 Copay	$250 Copay
Specialty	Not Covered	Not Covered
Saver HSA Plan
Generic	100% Covered*	100% Covered*
Preferred Brand	100% Covered*	100% Covered*
Non-Preferred Brand	100% Covered*	100% Covered*
Specialty	Not Covered	Not Covered
* After Deductible
Freedom Plans - Platinum, Gold, Silver and Bronze
Generic	$10 Copay	$25 Copay
Preferred Brand	Not Covered	Not Covered
Non-Preferred Brand	Not Covered	Not Covered
Specialty	Not Covered	Not Covered

Did you know there are coupon and price comparison sites for prescriptions?

Check out these sites and see if you are paying too much.