Pharmacy Benefits
Both Health Plan Levels: Ultimate and Best have the same Prescription Benefits with identical cost sharing. As of 01/01/2022, there are no more preferred network pharmacies.
Your benefits include:
- 90 Day Supply
- $10 co-pay per month for generics (one month is $10, three months is $30)
- Minimum of $15 co-pay for preferred brand medications or 25% of the approved cost
- Minimum of $40 co-pay for non-preferred brand medications or 45% of the approved cost
- The maximum out of pocket expense per 30-day prescription is $100 and $300 per 90-day prescription.
*Maximum out of Pocket Expenses can be adjusted annually by Board of County Commissioners, refer to the benefits section for current values.
Our Pharmacy Benefits Specialist can help you with:
- Transferring a medication to a preferred pharmacy to save money or create more convenience
- Understanding a new prescription and the potential side effects
- Accessing copay assistance and coupons for your high-cost medications
- Getting an early fill on your medications before going out of town or on vacation
- Questions about your Health Benefits
Email keara.reaves@mymanatee.org or call 941-748-4501, ext. 6418
Specialty Pharmacy Benefit
Minimum of 25% up to $150 Prescription Maximum Out-of Pocket Expenses. This applies to brand and generic specialty medications.
Mail Order Benefit
You can use mail order services offered through OptumRx to fill your prescriptions. Go to the Optum Rx Website or call 800-562-6223 for details.
