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Prescription Drugs, continued
Here are the prescription drug plans that are offered with our Aetna Medical HDHP plan.
Aetna Medical HDHP Plan
In-Network
Out-Of-Network
Prescription Drug
Deductible
Prescriptions subject to medical plan
deductible
N/A
Annual Out-of-Pocket
Limit
Prescriptions subject to medical out-
of-pocket maximum
N/A
Pharmacy
Generic
$10 copay then plan pays 100% after
deductible
Not covered
Preferred Brand
$40 copay then plan pays 100% after
deductible
Not covered
Non-preferred Brand
$60 copay then plan pays 100% after
deductible
Not covered
Supply Limit
30 days
N/A
Mail Order
Generic
$20 copay then plan pays 100% after
deductible
Not covered
Preferred Brand
$80 copay then plan pays 100% after
deductible
Not covered
Non-preferred Brand
$120 copay then plan pays 100%
after deductible
Not covered
Supply Limit
90 days
N/A