Page 8 - Community Health Systems Guide 2020 v2 (CHSI Review)

Anthem Prescription Drugs

The Anthem Blue Cross medical plans include prescription drug coverage for you and your covered dependents.

Retail Pharmacy
Use a retail pharmacy to fill prescriptions for acute conditions (conditions that do not require
the medication to be taken on a regular basis). At a participating pharmacy, you will receive
up to a 30 day supply of your prescriptions.

Mail Order Pharmacy – Maintenance Medication
You could pay less for the same medication when you use the mail order pharmacy.
The mail order pharmacy is a fast, easy and convenient way to save time and money on your
maintenance medications (drugs that you need to take regularly). You can order additional
supplies of medication at a discount. See below for details!

Anthem Blue Cross Anthem Blue Cross
Plan Name Anthem Classic HMO PPO HSA-H Anthem Blue Cross
20/40/250 admit/125 OP 1400/2800/3000 10/30 Classic PPO 750/30/50/2

Pharmacy Deductible None None Combined with medical
deductible
Retail Pharmacy
Deductible, $5 / $15
- Tier 1a / 1b $5 / $15 Copay $5 / $20 Copay
- Tier 2 $30 Copay Deductible, $40 Copay $30 Copay
- Tier 3 $50 Copay Deductible, $60 Copay $50 Copay
- Tier 4 30% up to $250
- Supply Limit 30% up to $250 30% up to $250
30 Days 30 Days 30 Days
Mail Order Pharmacy Deductible,
$12.50 / $37.50 Copay
- Tier 1a / 1b $12.50 / $37.50 Copay $12.50 / $50 Copay
- Tier 2 $90 Copay Deductible, $120 Copay $90 Copay
- Tier 3 $150 Copay Deductible, $180 Copay $150 Copay
- Tier 4 30% up to $250
- Supply Limit 30% up to $250 30% up to $250
90 Days 90 Days 90 Days

Pharmacy Tips

Use generic and over the counter drugs when available.
The best way to save on prescriptions is to use generic or over the counter medications as
opposed to brand name drugs. Generic drugs must use the same active ingredients as the
brand name version of the drug. A generic drug must also meet the same quality and safety
standards.

Use the mail order benefit for maintenance medications
To save money and time, consider using the mail order pharmacy to fill your maintenance
medications. Contact home delivery pharmacy at 1-833-203-1739 to get started.

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