PRESCRIPTIONS

Prescription Drug Coverage for Medical Plans
Your prescription drug program is administered by RxBenefits. To find individualized information on your benefit coverage, search for network pharmacies or view the Covered Drug List, contact customercare@rxbenefits.com or call 800-334-8134.

Per Fill (Up to 30-day supply)	Complete Plan Tier 1	Balanced Plan Tier 1	Healthy Start
Preferred Generic	$0 Co-pay	$0 Co-pay	$0 Co-pay
Non-Preferred Generic	$25 Co-pay¹	$25 Co-pay¹	Discounts Available
Value Brand	$50 Co-pay¹	$50 Co-pay¹	Discounts Available
Non-Preferred Brand	30% after deductible	30% after deductible	Discounts Available
Specialty Drug	50% after deductible	50% after deductible	Not Covered

Generic Drugs
One way to get more value from your health care plan is to use generic drugs when they are available. Generic drugs work the same as costlier brand-name products. They have the same active ingredients and must pass the same quality standards. Cost is the main difference between generic and brand name prescription drugs. A generic is not always prescribed and is not always available, but that shouldn’t stop you from asking for the generic every time.

Value Brand Drugs
Value Brand drugs are commonly prescribed brand-name drugs identified by NBFSA as providing the greatest value compared to their higher-cost brand name alternatives.

Non-Preferred Brand Drugs
Non-preferred brand-name drugs typically cost more and are newer drugs on the market. Often, their high cost reflects the manufacturer’s development and marketing costs. You can be a wiser consumer by doing your research, asking the right questions and buying at the lowest price.

Step Therapy
The step therapy program encourages safe and cost-effective medication use. Under this program, a “step” approach is required to receive coverage for certain high-cost medications. This means that you must have prescription history with a first-line drug before the plan will cover a second-line drug. A first-line drug is recognized as safe and effective in treat¬ing a specific medical condition, as well as being cost-effective. A second-line drug is a less-preferred or more costly treatment option.

Step 1: When possible, your doctor should prescribe a first-line medication appropriate for your condition.
Step 2: If your doctor determines that a first line drug is not appropriate for you or is not effective for you, your prescription drug benefit will cover a second-line drug when certain conditions are met.

If you have benefit questions, send them to psbenefits@clubcorp.com or call Benefits Department at 800-800-4615.