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Anthem Prescription Drug Benefit
Anthem Network Prescription Drug Benefits
Both the Anthem Blue Preferred Primary HMO coverage and
the Anthem Blue Access PPO coverage provide Network prescription drug
benefits. An eligible prescription must be dispensed by a participating
pharmacy in the Anthem plan selected. This benefit is payable for a
prescription drug for a maximum supply of 30 days.
|
Drug |
Copayment at Time of Purchase |
|
Generic Drug on Anthem Formulary |
$8 |
|
Brand-name drug on Anthem Formulary |
$25 |
|
Drug not on Anthem Formulary |
$40 |
Anthem Non-Network
Prescription Drug Benefits
Employees covered by the Anthem Blue Access PPO
coverage are eligible for a Non-Network benefit when a prescription for a 30
day or less supply of a medication is filled by a Non-Network pharmacy.
This benefit is a 50% of cost reimbursement after the patient has
satisfied the $250 annual Non-Network deductible. The patient must file
a claim for this reimbursement. There is no Non-Network prescription drug
benefit with the Anthem Blue Preferred Primary HMO coverage.
WSU
Maintenance Drug Benefits
Benefits under the WSU Maintenance Drug Plan are
available to all employees and their covered dependents who are insured by
one of the Anthem Blue Cross and Blue Shield medical plans through the
university. Maintenance drug benefits are only available from the Wright
State University Pharmacy at the Frederick A. White Health Center or by mail
from Express Scripts Inc. in St. Louis, Missouri. A maintenance drug
benefit is only applicable for a 30 to 90 day supply of a prescription
medication.
|
Drug |
Copayment at Time of Purchase |
|
Generic Drug |
$12 |
|
Brand-name drug with no generic equivalent |
10% of
cost
(minimum
of $22)
|
|
Brand-name drug purchased when there is a suitable
generic equivalent |
10% of
cost
(minimum
of $60)
|
To fill a prescription under the
WSU Maintenance Drug Plan at the WSU Pharmacy, the insured must show his or
her Anthem Blue Cross and Blue Shield identification card. To fill a
prescription under the WSU Maintenance Drug plan through Express Scripts
Inc., the insured must mail the prescription and an Express Scripts claim
form to Express Scripts in St. Louis, Missouri. Normal turnaround time for
filling a prescription with Express Scripts is approximately 10 days to 2
weeks.
Print the Prescription
Drug Claim Form (PDF) to file for a prescription drug benefit
under the Anthem Blue Access PPO Plan or the Anthem Blue Preferred Primary
HMO Plan when you have been unable to purchase the medication using your
Anthem identification card.
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