Prescription Drug plans

We’ve got your pharmaceutical needs covered. Refer to the chart below for coverage levels for each medical plan option.

Value Plan, Core Plan and Savings Plan Drug Coverage

These Azuria medical plans provide prescription drug coverage through OptumRx. You must use a pharmacy in the OptumRx network to fill your prescriptions. Drugs are divided into four categories — generic, preferred brand, non-preferred brand and specialty medications — and the amount you pay depends on the category.

Find an OptumRx network pharmacy.

Prescription Benefits	Value Plan In-Network Only	Savings Plan In-Network Only	Core Plan In-Network Only
Prescription Drugs—Retail (30-day supply)
Generic	Preventive maintenance: Covered at 100%, no deductible All other drugs: 30% ($4 min./$100 max.), after deductible	20% ($10 min/$100 max)	$10
Preferred Brand			20% ($35 min/$100 max)	$35
Non-preferred Brand			20% ($60 min/$100 max)	$60
Specialty Medication			20% to $100/script	20% to $100/script
Prescription Drugs—Mail Order (90-day supply)
Generic	Preventive maintenance: Covered at 100%, no deductible All other drugs: 30% ($10 min./$200 max.), after deductible	20% ($25 min/$200 max)	2.5× retail
Preferred Brand			20% ($87.50 min/$200 max)	2.5× retail
Non-Preferred Brand			20% ($150 min/$200 max)	2.5× retail

Kaiser Permanente Prescription Drug Coverage

The plan offers prescription drug coverage through Kaiser, and you must use Kaiser facilities, physicians and pharmacies to receive coverage.

Prescription Benefits	Kaiser Plan
Prescription Drugs—Retail (30-day supply)
Generic Formulary	$10
Brand-Name Formulary or Non-Formulary	$30
Specialty Drugs	20% up to $200
Prescription Drugs—Retail (100-day supply)
Generic Formulary	$10
Brand-Name Formulary or Non-Formulary	$30

Contact Info

OptumRx

Call: 855.524.0381
Visit: optumrx.com

Kaiser Drug Plan

Call: 800.464.4000
Visit: kp.org

Medical Benefits	Value Plan In-Network Only	Savings Plan In-Network Only	Core Plan In-Network Only
Prescription Drugs — Retail (30-day supply)
Generic	Preventive maintenance: Covered at 100%, no deductible All other drugs: 30% ($4 min/$100 max), after deductible	20% ($10 min/$100 max)	$10
Preferred Brand			20% ($35 min/$100 max)	$35
Non-Preferred Brand			20% ($60 min/$100 max)	$60
Specialty Medication			20% to $100/script	20% to $100/script
Prescription Drugs — Mail Order (90-day supply)
Generic	Preventive maintenance: Covered at 100%, no deductible All other drugs: 30% ($10 min/$200 max), after deductible	20% ($25 min/$200 max)	2.5× retail
Preferred Brand			20% ($87.50 min/$200 max)	2.5× retail
Non-Preferred Brand			20% ($150 min/$200 max)	2.5× retail