Prescription drugs (Aetna and Horizon)
Prescription drug coverage
If you enroll in a medical plan through Aetna or Horizon Blue Cross Blue Shield, your prescription drug benefits will be provided by Express Scripts. You can visit express-scripts.com to find a pharmacy near you.
Use your Express Scripts identification card when purchasing any prescriptions to ensure you are charged the correct amount. If you have any questions, please call Express Scripts at 1-866-544-6884.
If you enroll in a medical plan through Kaiser, you will use the same identification card for both medical and prescription expenses.
The amount you pay for prescription drugs depends on the type of drug and how you fill your prescriptions.
Drug types
Generic drugs: Same active ingredients as brand-name equivalents and meet the same standards for quality and effectiveness but cost much less.
Preferred drugs: Brand-name medications included on the formulary based on effectiveness and cost.
Non-preferred drugs: Brand-name medications not preferred by your carrier. They may still be covered but may require prior authorization and cost more.
PPO Plans |
High deductible plans |
|||
|---|---|---|---|---|
| $400 Deductible1 | $900 Deductible | $1,850 Deductible | $3,200 Deductible | |
Retail: 30-day supply |
||||
|
Generic |
$15 |
30% (min. $10/max. $20), no deductible |
20% after deductible |
30% after deductible |
|
Preferred |
$40 |
30% (min. $25/max. $50), no deductible |
20% after deductible |
30% after deductible |
|
Non-preferred |
$80 |
45% (min. $40/max. $80), no deductible |
20% after deductible |
30% after deductible |
Mail order or Smart90 program: 90-day supply |
||||
|
Generic |
$37.50 |
30% (min. $25/max. $50), no deductible |
20% after deductible |
30% after deductible |
|
Preferred |
$100 |
30% (min. $62.50/max. $125), no deductible |
20% after deductible |
30% after deductible |
|
Non-preferred |
$200 |
45% (min. $100/max. $200), no deductible |
20% after deductible |
30% after deductible |
The pharmacy plans available under Kaiser vary and they work a little differently than the other carriers’ plans. For details, visit the Chubb Benefits Portal.
Filling prescriptions
If you are filling a prescription for a medication that you will be taking for the short term, take your Express Scripts ID with you to any participating pharmacy (such as your local grocery store or drug store) and fill your prescription. If you take any maintenance medications (for example, to manage your cholesterol or lower your blood pressure), you may get a 90-day supply through the mail-order program or pick up your medication at a participating local Walgreens retail pharmacy. Not filling a 90-day supply at Walgreens after exhausting your two grace retail fills may require that you pay the full price of the medication.
Please note that this program is not available to Kaiser members; more information about Kaiser prescription benefits is available on the Chubb Benefits Portal.
Express Scripts Cost Comparison Tool
Visit the Express Scripts Pricing tool to see the estimated cost of your medication under each deductible plan to help you save money on your prescription costs.
Want to pay less for prescription drugs?
You can save hundreds of dollars a year just by switching from a brand name to a generic or by switching from a capsule to a tablet or vice versa.
Register for RX Savings Solutions*, go to www.myrxss.com or download the Rx Savings Solutions app to find the best prescription drug prices. Medications will be displayed, along with all options to maximize your savings. You can also speak with a representative at RXSS by calling 1-800-268-4476.
*Not available to Kaiser members.