Pricing

The table below shows your co-payment for drugs, depending on the type of drug (generic, preferred or non-preferred) and whether you obtain the drug at a retail drug store or through the mail order pharmacy.

In-Network Retail Provider Mail Order
Generic drugs $5 co-pay for 30-day supply Mail order is $10 for a 90-day supply.
Preferred brand drugs $35 co-pay for 30-day supply Mail order is $70 for a 90-day supply.
Non-preferred brand drugs $60 co-pay for 30-day supply Mail order is $120 for a 90-day supply.
Specialty drugs Call CVS Specialty Pharmacy at 1-800-237-2767 for details.

The above co-payments are in effect for all active members, retired members not on Medicare.

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