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. *May reduce to $0 copay with optional program participation. |
After deductible. Tier 1 $20 copay *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 |
| Pharmacy summary plan document | ||
PROVIDER INFORMATION
1.844.257.1955
Human Resources
workP. 616.395.7811
hr@hope.edu