Prescription Drug Benefit

The prescription drug program is part of the medical plan and is administered by Navitus Health Solutions. Prescription drugs are subject to the medical deductible and then to three tiers of coinsurance up to the medical out-of-pocket maximum. Once you reach the medical out-of-pocket maximum, the plan will pay 100% of your eligible medical and prescription costs for the remainder of the calendar year.

The prescription drug program provides you with savings when you purchase prescriptions from participating pharmacies. The Navitus Network includes many independent stores, as well as widely known chains.

The prescription card is the same as your health insurance card. When the pharmacist enters your prescription, the Navitus system will tell the pharmacist if your deductible has been met. Once your deductible has been met, their system will calculate the appropriate coinsurance you need to pay, and your pharmacist will charge you for that amount. Navitus will reimburse the pharmacy for the balance.

Getting Your Prescriptions Through Mail Order

If you are taking a medication over an extended period, you can have it mailed directly to your home through the mail-order program. This feature makes buying medication for an ongoing condition (such as diabetes, high blood pressure or heart condition) more convenient. Not only does the drug come directly to your home, but you may be able to order up to a 90-day supply at a time at a reduced cost. To get started, complete the mail-order enrollment process online at www.ppsrx.com. You may also contact PPS Customer Care by phone. They can be reached toll-free at 1-800-552-6694.

The drug plan offers Postal Prescription Services (PPS), a subsidiary of The Kroger Company (a parent of Pick ‘N Save and Metro Market), as its mail-order pharmacy. Prescriptions can be mailed to your home, or you can pick up your prescription at a Kroger pharmacy at the same low mail-order price.

COVID-19 Test Kits

Vaccinations through Navitus

SpecialtyRx

Navitus SpecialtyRx works with our specialty partner, Lumicera Health Services, to offer services with the highest standard of care. You will get one-on-one service with skilled pharmacists. They will answer questions about side effects and give advice to help you stay on course with your treatment. With Navitus SpecialtyRx, there is no delivery charge, and the medication is sent right to your door or prescriber’s office. Local courier service is available for emergency, same day medication needs. To start using Navitus SpecialtyRx, please call toll-free 1-855-847-3553. Lumicera will work with your prescriber for current or new specialty prescriptions.

Tria Health Program

(for members who are identified with chronic medical conditions) 

6 for $6 Program at COSTCO

  • This program, through Navitus, features 40+ generic medications available to members for $6 for a six-month supply. It’s an exclusive partnership between Navitus and Costco Pharmacy.
  • This program is available at Costco’s 547+ retail pharmacy locations nationwide. You do not need to hold a Costco membership to participate.