Tier 0 Some highly cost-effective medications: Co-pay per 30-day supply if purchased at a “Trust Network” pharmacy: $0
- Cholesterol Lowering Medications (Simvastatin)
- Proton Pump Inhibitors (Prilosec OTC, with physician prescription)
- Non-sedating Antihistamines: Generic Claritin (Loratadine and Loratadine D)
Tier 1 Current generics, some future generics: Co-pay per 30-day supply if purchased at a “Trust Network” pharmacy: $5
Tier 2 Most brand drugs, and more costly or less desirable future generics: Co-pay per 30-day supply if purchased at a “Trust Network” pharmacy: $20
Tier 3 Non-preferred brand drugs and some undesirable future generics: Co-pay per 30-day supply if purchased at a “Trust Network” pharmacy: $30
Brand Name Drug with Generic Available
If you fill a prescription for a brand name drug when there is a generic, you will pay the generic co-pay plus the actual difference in cost between the generic and the brand name drug. If you do not identify yourself or dependents as a participants in the Sound Health & Wellness Trust to the pharmacist when your prescription is filled, you will be assessed a processing fee in addition to the co-pay. The processing fee for generic is $10; the processing fee for brand is $20.
Maintenance “Mail” at Retail
Tier 3 Maintenance Drugs:
$60 co-pay for a 90 day supply if purchased at certain “Trust Network” pharmacies.
Mail Order (optional):
Co-pays for a 90 day supply listed below:
- Tier 0 - $0
- Tier 1 - $15
- Tier 2 - $60
- Tier 3 - $90
- Brand Name Drug with Generic Available - Generic co-pay plus the actual difference in cost between the generic and the brand name drug
