2019 PPO & EPO Pharmacy Information

Anthem EPO Benefit Enhancement (Effective 1/1/2019):

All employees, excluding those enrolled in the HDHP, will now have the same pharmacy benefit. This change will reduce out of pocket maximum for those enrolled in the Anthem EPO plan.

Anthem Care PPO, Anthem Choice, Anthem Select & Anthem EPO

When Picking Up From an In-Network Retail Pharmacy

Annual Out-of-Pocket Limit

$2,000 individual / $4,000 family

Generic

$5 copay

Preferred Brand

$20 copay

Non-preferred Brand

$50 copay

Supply 

30 days

You could possibly save money switching to mail order over picking up at a retail pharmacy if you are on any maintenance medications. Your co-pay for a 1-month supply of a generic medication at a pharmacy is $5 or you can get the same medication, but a 3-month supply, for a $10 co-pay through mail order. Log on to your online Express Scripts account for more information.

                                                               Anthem Care PPO, Anthem Choice, Anthem Select & Anthem EPO                                                                  

When Receiving a 3-Month Supply Through Mail Order

Annual Out-of-Pocket Limit

$1,000 Mail Order

Generic

$10 copay

Preferred Brand

$40 copay

Non-preferred Brand

$100 copay

Compound Drug

N/A

Supply

100 days