Prescription Benefits


MAXOR

MaxorPlus is a national pharmacy benefit management (PBM) company founded with the goals of managing prescription benefit costs while providing better customer service than anyone on the industry.

If you have any questions or just want to know if your local pharmacy is participating, please call MaxorPlus Customer Service at 800.687.0707. You may also visit their website at www.maxorplus.com.


PRESCRIPTION DRUG COVERAGE

When you elect medical coverage, you are automatically covered under the prescription drug plan. This coverage allows you to fill your prescriptions at participating retail pharmacies.

Participating Pharmacy Preferred Pharmacy Network Performance 90 Network
Multi-source Generic Copay $4
Single-source Generic Copay $10
Brand Copay $40% of cost $40% of cost
Maximum Supply Allowed 30 Days 90 Days

There are multiple categories of drugs under the plan. The differences between these categories are described below:

  • A generic drug is one that meets the same standards as name brand drugs for safety, purity, strength and effectiveness. Generic drugs are less expensive than name brand drugs.
    1. A multi source generic drug is a generic drug with multiple manufacturers.
    2. A single source generic drug is a generic drug with exclusive manufacturing rights.

  • A single source drug is a name brand drug (patent protected) with no generic available.
  • A multi source drug is a name brand drug (patent expired) with a generic available.

Under this plan, you have the opportunity to lower the amount you pay by choosing a generic whenever possible. Be sure to discuss this option with your physician when he or she writes your prescription.

If you request a brand name drug when a generic is available, you will be responsible for paying the difference in price between the brand name and the generic drug added to the generic co-payment.

Only prescriptions obtained from participating pharmacies are covered by your prescription plan.


PRESCRIPTION MEDICATIONS NOT COVERED

  • Over-the-counter medications
  • Fertility medications
  • Vitamins except prenatals
  • Anti-obesity
  • Ostomy supplies
  • Smoking deterrents
  • Non-insulin syringes
  • Cosmetic drugs
  • Diagnostics
  • Diabetic supplies
  • Medical supplies and apparatus
  • Experimental and investigatory drugs
  • Medications administered while admitted to a medical facility
  • Medications covered by worker’s compensation or similar government program