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Prescription Drug Coverage

The Well Choice and Well Choice Select plans provide the same level of prescription drug coverage through Walgreens.

Your Prescription Drug Coverage At-a-Glance

Copay TierUp to a 30-Day Supply31- to 90-Day Supply
Generic
(Tier 1)
You pay $5 per prescription You pay $12 per prescription
Preferred Brand
(Tier 2)
You pay 20% coinsurance with a minimum copay of $30 and a maximum copay of $40 You pay 20% coinsurance with a minimum copay of $75 and a maximum copay of $100
Nonpreferred
(Tier 3)
30% coinsurance with a minimum copay of $47 and a maximum copay of $107 30% coinsurance with a minimum copay of $117.50 and a maximum copay of $267.50

Prescription Medication List

Refer to the Prescription Medication List for additional information about copay tiers and preferred brand drugs.

Your Prescription Drug Coverage

Filling a Prescription

You have three options to fill or refill a prescription:

  1. Walgreens pharmacy
  2. Walgreens Mail Service
  3. Mycatamaranrx.com (allows you to schedule refills for home delivery or pickup)

90-Day Mandatory Generic Maintenance Medications

The plan requires you to fill a 90-day supply of any generic maintenance medication after your third 30-day supply. This helps you and Walgreens save money by reducing the number of refills you receive.

If you do not get your fourth refill as a 90-day supply, you must pay the full price for the 30-day refill. Check with your pharmacist or ask your doctor to write the prescription for your generic maintenance medication for a 90-day supply, not for 30. In addition to using generic 90-day medications, you can save money by asking your doctor for 90-day preferred and nonpreferred brand maintenance medications, but it is not required.

Nebulizers and Peak Flow Meters

New for 2013! You can receive selected brand nebulizers and peak flow meters under your prescription benefit for a preferred copay.


 


More Prescription Drug Features

Zero Copay Program

If you are being treated for high cholesterol, coronary artery disease (CAD) or diabetes, you are eligible to receive certain medications related to your condition at a $0 copay.

Get more details about the 2013 Zero Copay Program

LIMITED TIME ONLY!
FREE TRUEresult Blood Glucose Monitor at Walgreens until March 31, 2014. Print your coupon now:

Zero Copay Program Medications and Test Strips

General

  • Atorvastatin
  • Cholestyramine
  • Cholestyramine Light
  • Colestipol
  • Fenofibrate
  • Fenofibric acid
  • Fluvastatin
  • Gemfibrozil
  • Lovastatin
  • Pravastatin
  • Prevalite
  • Simvastatin

Diabetes

  • Acarbose
  • Chlorpropamide
  • Glimepiride
  • Glipizide
  • Glipizide ER
  • Glipizide Metformin
  • Glipizide XL
  • Glyburide
  • Glyburide Metformin
  • Glyburide Micronized
  • Insulin Products, Preferred Brand
  • Metformin
  • Metformin ER
  • Nateglinide
  • Pioglitazone
  • Pioglitazone-Metformin
  • Tolazamide
  • Tolbutamide
  • Walgreens-brand Test Strips

Infertility Coverage

  • Generic and preferred medications have a 25% coinsurance and a minimum copay (generic $5/30-day, $12/90-day; preferred $30/30-day, $75/90-day).
  • Nonpreferred medications have a 30% coinsurance and a minimum copay ($47/30-day, $117.50/90-day).
  • Infertility drugs also have a $10,000 lifetime maximum benefit.

Walgreens Specialty Pharmacy

Walgreens offers a specialty pharmacy program designed for chronic, life-threatening or rare conditions. Specialty drugs are generally characterized as expensive medications with limited access, complicated treatment regimens, special storage requirements and/or manufacturer reporting requirements.

The Walgreens Specialty Pharmacy program allows up to a 30-day supply of medications to be filled through Walgreens Specialty Pharmacy or through a Walgreens retail pharmacy. This program provides educational support, side-effect management and access to on-staff pharmacists and nurses.

A new plan provision, which became effective on March 1, 2012, requires that certain specialty infusion medications must be provided exclusively through the prescription drug plan to be covered. This includes infusion medications for the following conditions:

  • Bleeding disorders (factor products)
  • Chronic inflammatory disorders (such as rheumatoid arthritis, psoriasis or Crohn’s disease)
  • Enzyme replacement therapies
  • Immunoglobulins

For more information, contact Walgreens Network Health Services at 855-ASK-WNHS (275-9647).

Step-Care and Prior Authorizations

Certain conditions require step-care and prior authorization for medications to help ensure appropriate drug treatment while managing overall pharmacy costs. These programs sometimes require extra steps when getting prescriptions filled. To avoid delays, check whether your medication requires prior authorization or a step-care plan before getting your prescription filled. Call the Catamaran Rx Clinical Care Center at 877-665-6609 for more information.

The following medications require prior authorization for quantities exceeding clinical dosing and safety guidelines. Categories and examples of these medications include:

  • Angiotension Receptor Blockers/Renin Inhibitors: losartan, Diovan
  • Antidepressants: sertraline, citalopram
  • Antipsychotics: Abilify
  • Bisphosphonates: alendronate, ibandronate
  • Cardiovascular medications: Pradaxa, Zarelto
  • Family Planning/Hormone Replacement: Ella, Plan B
  • Inhaled Nasal Corticosteroids: fluticasone
  • Proton Pump Inhibitors: omeprazole
  • Respiratory: Proair HFA, Advair Diskus
  • Supplies and Miscellaneous: Glucagon, Novopen Insulin Device

This list is subject to change. Please visit www.mycatamaranrx.com or call Catamaran Rx at 800-207-2568 for more information about your specific medication.

DailyMed

DailyMed is available to all Walgreen Prescription Drug Plan participants. DailyMed is a service to organize and monitor prescriptions for those who take multiple medications on a daily basis. Visit www.dailymedrx.com or call 855-RX-DAILY (855-793-2459) for more information.