Page 9 - Busey 2020 Benefits
P. 9
PRESCRIPTION DRUG COVERAGE
New for 2020, prescription drug beneits under all plans will be offered
through Express Scripts. Our plan will utilize Express Scripts’ full
network.
The below chart outlines the beneits for the prescription drug plan. The
prescription drug beneits on these plans are based on whether the drug is
considered a generic, preferred brand, or non-preferred brand. Our plan
allows for a 30-day supply at a retail pharmacy, or a 90-day supply through
mail order. When possible, we encourage you to get your maintenance
drugs illed through mail order. There are usually signiicant savings and
you have the added convenience of it being shipped directly to your
home.
With a CDHP plan, all prescription drugs are subject to the medical
deductible before cost sharing begins. You will, however, see 100%
coverage on certain preventive medications under the CDHP plan.
Prescription Drugs
POS 2800 CDHP POS 5000 CDHP
Retail— 30 days 30 days
Supply Limit
Tier 1 80% after 50% after 100% after 50% after
deductible deductible deductible deductible
Tier 2 80% after 50% after 100% after 50% after
deductible deductible deductible deductible
Tier 3 80% after 50% after 100% after 50% after
deductible deductible deductible deductible
Mail Order—
Supply Limit 90 days 90 days
Tier 1 80% after 100% after
deductible deductible
Tier 2 80% after 100% after
deductible Not covered deductible Not covered
Tier 3 80% after 100% after
deductible deductible
First Busey Corporation 9
New for 2020, prescription drug beneits under all plans will be offered
through Express Scripts. Our plan will utilize Express Scripts’ full
network.
The below chart outlines the beneits for the prescription drug plan. The
prescription drug beneits on these plans are based on whether the drug is
considered a generic, preferred brand, or non-preferred brand. Our plan
allows for a 30-day supply at a retail pharmacy, or a 90-day supply through
mail order. When possible, we encourage you to get your maintenance
drugs illed through mail order. There are usually signiicant savings and
you have the added convenience of it being shipped directly to your
home.
With a CDHP plan, all prescription drugs are subject to the medical
deductible before cost sharing begins. You will, however, see 100%
coverage on certain preventive medications under the CDHP plan.
Prescription Drugs
POS 2800 CDHP POS 5000 CDHP
Retail— 30 days 30 days
Supply Limit
Tier 1 80% after 50% after 100% after 50% after
deductible deductible deductible deductible
Tier 2 80% after 50% after 100% after 50% after
deductible deductible deductible deductible
Tier 3 80% after 50% after 100% after 50% after
deductible deductible deductible deductible
Mail Order—
Supply Limit 90 days 90 days
Tier 1 80% after 100% after
deductible deductible
Tier 2 80% after 100% after
deductible Not covered deductible Not covered
Tier 3 80% after 100% after
deductible deductible
First Busey Corporation 9
