HDHP Pharmacy
Pharmacy benefits for the Anthem High Deductible Health Plan (HDHP) are provided by IngenioRx. There are no changes to the 2019 HDHP pharmacy benefits for 2020. Please click here for the formulary.
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Annual Deductible
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Medical Deductible Applies
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Annual Out of Pocket Max
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Medical out-of-pocket maximum Applies
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Generic
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Pharmacy: 20% after Rx deductible; Mail Order: 20% after Rx deductible
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Preferred Brand
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Pharmacy: 20% after Rx deductible; Mail Order: 20% after Rx deductible
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Non-Preferred Brand
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Pharmacy: 20% after Rx deductible; Mail Order: 20% after Rx deductible
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Supply Fill
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Pharmacy: 30 days; Mail Order: 90 days
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You pay 100% of pharmacy costs until you meet the plan's deductible. This means if your prescription costs $100, you will need to pay the $100 each time you pick it up until you reach your deductible. You do NOT have a set co-pay. Once you meet your deductible, you will have co-insurance coverage, meaning you will pay 20% of your prescription’s cost. If your prescription costs $100 and you have met your deductible, you will pay 20% ($20) and the plan will cover the remaining 80% ($80). Once you reach your annual out-of-pocket maximum, the plan will pay 100%.
To help manage the costs of your prescriptions, there are resources like GoodRX that will help you find a pharmacy near you with the lowest cost for your prescription.