Find the Exact Cost of Your Drugs
Find out the cost of a medication before you get to the pharmacy by using the Drug Cost Preview tool:
- Go to the Navitus ETF Benefits website.
- Select your health plan design.
- Select Drug Cost Preview.
Breakdown of Your Pharmacy Costs
Each covered prescription drug falls into one of four cost-sharing levels. The lower the level, the less you pay. The table below shows how much you will pay for drugs in each level, and the maximum amount you will pay for covered drugs each year.
You must fill your prescriptions at an in-network pharmacy. Find an in-network pharmacy. In-network pharmacies are available nationwide.
| IYC Local High Deductible Health Plan | |
|---|---|
|
Prescription Deductible Individual / Family |
Combined medical and pharmacy: $1,600 / $3,200 You pay 100% of most pharmacy costs until the deductible is met.1 |
|
Prescription Copay / Coinsurance Level 1 |
After deductible: $5 or less |
|
Level 2 |
After deductible: 20% ($50 max) |
|
Level 3 |
After deductible: 40% ($150 max)2 Level 3 “Dispense as Written” or “DAW-1” drugs may cost more. |
|
Level 4 |
After deductible: $50 copay3 Must fill at Lumicera Health Services specialty pharmacy or UW Health Speciality Pharmacies. |
|
Preventive prescriptions |
$0 - Plan pays 100%, regardless of deductible, as federally required |
|
Prescription Out-of-Pocket Limit (OOPL) Levels 1, 2, 3, & 4 Individual / Family |
Combined medical and pharmacy: $2,500 / $5,000 |
1 Before you meet your deductible, preventive drugs are covered 100% and certain maintenance medications only require a copayment or coinsurance.
2 For Level 3 “Dispense as Written” or “DAW-1” drugs, your doctor must submit a one-time FDA MedWatch form to Navitus. If there is no form on file with Navitus, you will pay more. Contact Navitus at 1-866-333-2757 for details.
3 Must fill at Lumicera Health Services specialty pharmacy or UW Health Specialty Pharmacies.
