Prescriptions – CEL Benefits

Prescriptions

Have questions about your prescription coverage?

Learn about your benefits, costs, formulary lists and any coverage restrictions by contacting your Pharmacy Benefit Manager (PBM) listed below.

If you prefer talking with a HealthEZ representative, call 888-592-6267

Prescription Drug Coverage

	Retail 30 Day Suppy	Mail Order 90 Day Supply
Copay 2 Plan
Generic	$10 Copay	$25 Copay
Preferred Brand	$30 Copay	$75 Copay
Non-Preferred Brand	$60 Copay	$150 Copay
Specialty	$10/$30/$60 Copay	Not Available
HSA 4 Plan
Generic	$10 Copay After Deductible	$25 Copay After Deductible
Preferred Brand	$25 Copay After Deductible	$62.50 Copay After Deductible
Non-Preferred Brand	$50 Copay After Deductible	$125 Copay After Deductible
Specialty	$10/ $25/ $50 Copay After Deductible	Not Available
HSA Plan 1
Generic	$10 Copay	$25 Copay
Preferred Brand	$25 Copay	$120 Copay
Non-Preferred Brand	$45 Copay	$180 Copay
Specialty	30% Coinsurance* up to $250	Not Available

Did You Know?

Did you know there are coupon and price comparison sites for prescriptions?

Check out these sites and see if you are paying too much.