Campbell County's prescription drug coverage benefit is administrated by Innoviant. Both a mail order and a retail pharmacy service are available. Contact Innoviant at 1-877-559-2955, Monday through Friday, 6:30 a.m. until 6:00 p.m. MST or visit their web site at http://www.innoviant.com. |
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Below are significant changes to our prescription drug coverage effective January 1, 2007.
GENERIC |
BRAND FORMULARY |
BRAND NON-FORMULARY |
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RX PLAN |
Retail
|
Mail Order |
Retail |
Mail Order |
Retail Co-Pays Per Month |
Mail Order |
Prescription |
$10 | $15 | Patient pays $20 + 20% of balance, subject to max total co-pay of $80 | Patient pays $40 + 20% of balance, subject to max total co-pay of $160 | Patient pays $35 + 30% of balance, subject to max total co-pay of $150 | Patient pays $75 + 30% of balance, subject to max total co-pay of $300 |
Example 1: If you take a brand formulary prescription with the original price of $100.00. The patient would pay:
$20.00 Co-pay
$16.00 (20% of $80.00 - remaining balance)
$36.00 Total cost to employee
Example 2: If you take a brand non-formulary prescription with the original price of $200.00. The patient would pay:
$35.00 Co-pay
$49.50 (30% of 165.00 - remaining balance)
$84.50 Total cost to employee
More information regarding benefits can be found in the Personnel & Benefit binders as well as by contacting the HR Department. All benefits are subject to eligibility requirements and may change at any time. In the case of a difference between the above listed information and the master policies, the master policies will be controlling.