Page 8 - Dent Wizard 2018 New Hire Guide 0123.18

Prescription Drug Coverage
Administered by Aetna
The prescription drug plan is included with the medical plan. The amount you pay for each prescription depends on whether the drug is a brand name or a generic and where you have the prescription filled. Dent Wizard’s medical plan uses the Aetna Premier Formulary (complete list of medications included is listed on www.AetnaNavigator.com). Some of the prescription drug plan features are:
Maintenance Choice Prescription Drug Program
You can use any in-network pharmacy you choose to fill your prescriptions, you must refill maintenance medications, (medications that you take daily on an ongoing basis like insulin, drugs to control cholesterol, etc.), at either a CVS or Target retail pharmacy
or Aetna Rx Home Delivery.
BRAND NAME PRESCRIPTION DRUG COSTS
Retail
Aetna RX Home Delivery – CVS/Target
$10 co-pay for generic drugs (30 days)
$20 copay for generic (90 days)
$40 for formulary brand-name drugs (30 days)
$80 for preferred brand-name drugs (90 days)
$60 for non-formulary brand-name drugs (30 days)
$120 for non-preferred brand-name drugs (90 days)
Deductible: $150 Person / $450 Family
Deductible must be satisfied before any drug benefits are paid. Deductible does not apply to any mail order drugs or generic retail drugs.
If you choose a brand-name when a generic is available, you pay the cost difference between the generic and brand-name including the deductible if applicable.
Choose Generic Drugs and Save!
Dent Wizard’s plan has specific terms that help you pay less when you choose generic drugs. Taking a generic is an easy way
to reduce your out-of-pocket costs. They are safe, effective and often cost less
than their brand-name counterparts.
To help you save money, the prescription drug plan requires you to use a generic drug when one is available, in order to get the best coverage.
Your pharmacy will automatically fill your prescription with a generic if one is available. Please know that if a generic is available, and you choose to get the brand instead, you may pay more. You will pay the difference in cost between the brand and generic, plus the applicable co-pay for your plan.
8 Choose Your Destination – Design Your Plan.