Pharmacy

All four Health Plan Levels: Basic, Better, Best, and Ultimate have the same Prescription Benefits with identical cost sharing. Filling your prescriptions at Preferred Network pharmacies offers the best opportunity to save money on your prescription costs.

Preferred Network Pharmacies

Pelots
831 Manatee Ave. East
Bradenton, FL 34208
(941) 748-8130

Winn Dixie (nationwide)

Apothicare at Lakewood Ranch
8618 E State Road 70
Bradenton, FL 34202
(941)751-5000

Your benefits at Preferred Network Pharmacies include:

• 90 Day Supply
• $5 co-pay per month for generics (one month is $5, three months is $15)
• Minimum of $15 co-pay for preferred brand medications or 25% of the approved cost
• Minimum of $40 co-pay for non-preferred brand medications or 45% of the approved cost
• The maximum out of pocket expense per 30-day prescription is $100 and $300 per 90-day prescription.

*Maximum out of Pocket Expenses can be adjusted annually by Board of County Commissioners, refer to the benefits section for current values.

Non-Preferred Retail Network Pharmacy Benefit

You can still fill your prescription at other network pharmacies but be aware that your co-pay amounts may be higher than those at Preferred retail pharmacies.

Your benefits at non-preferred retail pharmacies include:

• Maximum 30 Day Supply
• Minimum of $15 co-pay for generics or 20% of the approved cost
• Minimum of $20 co-pay for preferred brand medications or 30% of the approved cost
• Minimum of $50 co-pay for non-preferred brand medications or 55% of the approved cost
• The maximum out of pocket expense per 30-day prescription is $100.

Specialty Pharmacy Benefit

Minimum of 25% up to $150 Prescription Maximum Out-of Pocket Expenses. This applies to brand and generic specialty medications.

Mail Order Benefit

You can use mail order services offered through OptumRx to fill your prescriptions. Go to the Optum Rx Website or call 800-562-6223 for details.

Your mail order benefits include:

• Up to 90 Day Supply
• Minimum of $18 co-pay for generics or 15% of the approved cost
• Minimum of $38 co-pay for preferred brand medications or 25% of the approved cost
• Minimum of $100 co-pay for non-preferred brand medications or 50% of the approved cost
• The maximum out of pocket expense per 30-day prescription is $100 and $300 per 90-day prescription.