NRECA's Copayment Plan
In addition to paying the monthly premium, you pay these costs each year when using the benefit:
Step 1
For the first $2,830 in total drug costs, you pay only the copayment for each covered drug, depending on the type of drug you choose. The Plan pays all other drug costs.
|
You Pay
|
Plan Pays
|
|
Type of Pharmacy
|
Generic
|
Preferred Brand
|
Non-Preferred Brand
|
Specialty
|
| Retail up to 30 days |
$5 |
$25 |
$40 |
$50 |
Drug costs after copayments |
| Retail 31-90 days |
$15 |
$75 |
$120 |
Up to
30-day
supply
only
|
Drug costs after copayments |
| Mail order |
$10
for up to
90-day supply |
$50
for up to
90-day supply |
$80
for up to
90-day supply |
$50
for up to
30-day supply
|
Drug costs after copayments |
Step 2
Then you have a coverage gap when you pay 100% of the cost for covered preferred brand, non-preferred brand and specialty drugs. You pay only the copayment for generic drugs. For generic drugs, the Plan pays all other drug costs.
|
You Pay
|
Plan Pays
|
|
Type of Pharmacy
|
Generic
|
Preferred Brand
|
Non-Preferred Brand
|
Specialty
|
| Retail up to 30 days |
$5 |
100% |
100% |
Up to
30-day
supply
only |
Drug costs after copayments |
| Retail 31-90 days |
$15 |
100% |
100% |
100% |
Drug costs after copayments |
| Mail order |
$10 |
100% |
100% |
100% |
Drug costs after copayments |
Step 3
Once you have paid $4,550 -- the maximum in true out-of-pocket costs for 2010 -- you are eligible for catastrophic coverage.
The Plan pays 100% of the cost of covered drugs once you reach catastrophic coverage. You pay nothing for the rest of the year.