/ Human Resources

Prescription Plans At a Glance

2025/26 in-network plans

  Blue (Traditional) Plan Orange (HDHP) Plan
Deductible Not applicable. Pharmacy costs combine with medical plan deductibles.
Maximum out of pocket Pharmacy co-pays combine with medical plan limits Pharmacy co-pays combine with medical plan limits
preventive drug per aca guidelines $0 copay $0 copay
for short term medications (up to a 30 day supply) - Effective 1-1-2026
open retail pharmacy network

Not subject to deductible.

Tier 1 $20 copay
Tier 2 $50 copay
Tier 3 $100 copay
Specialty Tier 1:  30%*
Specialty Tier 2:  50%*

*May reduce to $0 copay with optional program participation.

After deductible.

Tier 1 $20 copay
Tier 2 $50 copay
Tier 3 $100 copay
Specialty Tier 1:  30%* 
Specialty Tier 2:  50%*

*May reduce to $0 copay with optional program participation.

for long term maintenance medications (up to a 90 DAY SUPPLY) - Effective 1-1-2026
open retail or mail service  pharmacy network Not subject to deductible.

Tier 1 $40 copay
Tier 2 $100 copay
Tier 3 $200 copay
Specialty drugs not eligible, due to maximum 30-day supply limit.

After deductible.

Tier 1 $40 copay
Tier 2 $100 copay
Tier 3 $200 copay
Specialty drugs not eligible, due to maximum 30-day supply limit.

Pharmacy summary plan document