Kaiser Northern California Prescription Drug Coverage

2020 and 2021 Plan Year Information

Prescription Drug Deductible and Out-of-Pocket Maximum

This Medical Plan does not have a separate deductible or out-of-pocket maximum for prescription drugs. Your prescription drug copays count toward the annual deductible and out-of-pocket maximum amounts.

Kaiser Permanente Prescription Drug Coverage

Participating Retail PharmacyMail Service
Generic Drug

$10 copay for up to 30-day retail supply

$20 copay for 100-day mail order supply

Preferred and Non-Preferred Brand Name Drugs

$30 copay for up to 30-day retail supply

$60 copay for up to 100-day mail order supply

Specialty Drugs

Subject to Kaiser’s determination. Contact Kaiser for details.
20% coinsurance up to $150 maximum for up to 30-day supply. Participating Retail Pharmacies only.

Subject to Kaiser’s determination. Contact Kaiser for details.
Subject to Kaiser’s determination. Contact Kaiser for details.