Prescription Benefits
Prescription coverage is provided to individuals enrolled in the group health plan at no additional cost. Benefits are administered by Liviniti.
MEMBER CO-PAY REQUIREMENTS
Local Retail Pharmacy: 1-90 Day Supply
Up to 90-Day Supply Available with One Co-Pay per 30-Day Supply
| Generic Drugs | $0 |
| Preferred Brand Drugs | 20% ($20 min / $150 max) |
| Non-Preferred Brand Drugs | 40% ($40 min / $150 max) |
Mail-Order Pharmacy: 31-90 Day Supply
| Generic Drugs | $0 |
| Preferred Brand Drugs | 20% ($60 min / $450 max) |
| Non-Preferred Brand Drugs | 40% ($120 min / $450 max) |
| Specialty Drugs | 40% ($150 max) |
Coverage for eligible employees begins the first day of the first full month following the date of hire.
Note: Brand drugs with Generic equivalents (DAW2), patient pays 100% of discounted drug cost (retail & mail).
If you regularly take the same medications, the Liviniti Home Delivery program may allow you to get a 90-day supply for a lower cost, saving you trips to the pharmacy and time waiting in line.
DRUGS NOT COVERED BY PLAN
- Drugs for Cosmetic Use
- Nutritional Supplements
- Fertility Drugs
- Implantable Contraceptives
DRUG LIMITATIONS
- Smoking Deterrents limited to 6 months therapy
- Prior authorization required for ADD medications for members < 22 years of age
- Prior authorization required for Acne Products for members < 21 years of age
- Immunomodulators require prior authorization.
Note: Gastric acid reducer drugs or PPIs – Proton Pump Inhibitors (ex: Nexium, Prilosec, Dexilant, Aciphex, Lansoprazole, Pantoprazole) are covered with 100% member copay of discounted price.
SPECIALTY AND HIGH COST MEDICATION PROGRAMS
- Variable Co-Pay Program (Liviniti)
- Manufacturer’s Assistance Program (Script Sourcing)
- Participation may be required for some members.
- You will be contacted by Liviniti or Script Sourcing if participation is required.
Would you like more information?
A plan description, formulary, and related forms can be found on County Connect and at: Liviniti.com
To find a network pharmacy:
Speak with a Liviniti representative at 1.833.395.5553 or search online at:
Liviniti.com