Archives
Mail Service Specialty Drugs
Not available $60 for up to 100-day supply
Mail Service Preferred and Non-Preferred Brand Name Drugs
Not available $60 for up to 100-day supply
Mail Service Generics
Not available $30 for up to 100-day supply
Mail Service Tier 5: Other Brand Name Specialty Drugs
Not covered
Mail Service Tier 4: Preferred Specialty Drugs
Not covered
Mail Service Non-Formulary Drugs
$400 copay for 90-day supply
Mail Service Brand/Specialty Drugs
$100 copay for 90-day mail order supply
Mail Service Other Generics
$30 copay for 90-day mail order supply
Mail Service Generics for Maintenance Medications
$6 copay for 90-day mail order supply
Mail Service Specialty Drugs
Subject to Kaiser’s determination. Contact Kaiser for details. Subject to […]
Mail Service Preferred and Non-Preferred Brand Drugs
$60 copay for up to 100-day mail order supply
Mail Service Generic Drugs
$20 copay for 100-day mail order supply
Mail Service Tier 3: Other Brand Name Drugs
$65 copay for 90-day mail order supply
Mail Service Tier 2: Preferred Brand Name Drug
$65 copay for 90-day mail order supply
Mail Service Tier 1: Generic Drug
$11 copay for 90-day mail order supply
Mail Service Family Annual Out-of-Pocket Maximum
$4,200 (combined with Participating and Non-Participating Retail Pharmacy)
Mail Service Individual Annual Out-of-Pocket Maximum
$3,600 (combined with Participating and Non-Participating Retail Pharmacy)