Pharmacy Cost-Saving Programs for Active Members Enhanced PPO Plan (80/20)

Shop Around!

Be sure to shop around for your generic prescriptions to make sure you're getting the best price for your medication. Many national and local retail pharmacies offer generics at discounted prices. CVS Caremark Pharmacy a​lso offers State Health Plan members lower cost generics on a mail-order basis.

Most of the lower cost prescription programs offer generic medications at $4 for a one-month supply or $10 for a three-month supply. However, each program offers generics at varying prices and some pharmacies require a fee to join their discount prescription program. Each pharmacy has a unique program with different generic medications included at the discounted price.

Compare the Cost of Alternative Prescriptions

Caremark.com is an online tool that may help lower your prescription drug costs. With Caremark.com you can easily identify potential cost-saving alternatives for any of your prescriptions which will allow you to make more cost-effective choices.

If you are a first-time visitor to Caremark.com, it's easy to register. Simply click "Register" at the top of the page and follow the instructions. You'll need your member ID number and the number of a recent prescription.

Copay Assistance Cards and How They Affect Your Deductible

Prescription copay cards are offered by drug manufacturers and processed through CVS Specialty Pharmacy to help prescription users meet medication costs. The State Health Plan does not offer nor manage copay cards, but we do allow members to take part in these programs to assist with the high cost of medication.

Please note: Only the amount you actually pay for the prescriptions will be applied towards your deductible or out-of-pocket maximum, when using a third party or manufacturer copay card program or coupon. For example, if a member’s copay is $2,000 and the copay card paid $1,995, you paid $5 and the $5 paid would apply to the deductible or out-of-pocket maximum.  In many circumstances the copay card pays all of the costs, resulting in no cost to the member. In this situation nothing would apply to the member’s accumulations because they did not pay anything out-of-pocket.

Overall, your deductible and out-of-pocket maximum include the amounts you actually pay out of pocket. Using a copay card lowers your out-of-pocket expenses, assisting with the expense of the medication, but does not affect your deductible or out-of-pocket maximum.