Prescription Benefit

Prescription Benefit

Administered by Express Scripts, Inc.

  • Reduced price, three-month home delivery option for maintenance drugs direct from Express Scripts
  • $1250 maximum out-of-pocket for individual; $2500 maximum out-of-pocket for family
  • Three levels of coverage:
  Generic Brand Formulary Brand Non-formulary
Home delivery (three months) $16 co-pay $85 co-pay $140 co-pay
Retail (monthly) $8 co-pay $40 co-pay $65 co-pay
Swedish Covenant Hospital (monthly)* $5 co-pay $20 co-pay $40 co-pay

*Retirees over 65 not eligible for discounted co-pays at Swedish Covenant Hospital

  • Download Formulary, claim forms and more here.