Prescription drugs

What you need to know

Do you take an ongoing prescription? Skip the line at the pharmacy, and use the mail-order service. You can order online, and your prescription will be mailed to your door.

Both medical plans include prescription drug coverage. The Kaiser HMO provides coverage through its network pharmacies and mail-order services.

The HMSA PPO plan provides coverage through the CVS Caremark pharmacy network and mail-order service.

You can get a fill or refill of up to a 30-day supply at a retail pharmacy and up to a 90-day supply through the mail-order service.

Find a pharmacy or use the mail-order service

To locate a pharmacy near you, learn more about or get started with the mail-order service, go to Kaiser or HMSA.

What you pay for prescriptions

Kaiser HMO

  In-Network
Generic at pharmacy $3 (maintenance)
$10 (non-maintenance)
Generic mail order $6 (maintenance)
$20 (non-maintenance)
Preferred brand-name at pharmacy $45
Preferred brand-name mail order $90
Non-preferred brand-name at pharmacy Not covered
Non-preferred brand-name mail order Not covered
Specialty medications $200

 

HMSA PPO

The HMSA PPO has a separate out-of-pocket maximum for prescription drugs of $3,600 individual and $4,200 family.

  In-Network
Generic at pharmacy $7
Generic mail order $11
Preferred brand-name at pharmacy $30
Preferred brand-name mail order $65
Non-preferred brand-name at pharmacy $75
Non-preferred brand-name mail order $200
Specialty medications $100 (Preferred brand)
$200 (Non-preferred brand)