Pharmacy Plan

Public Entity Members - Check with your employer to see which plans are available to you.

All medical coverage includes MCHCP’s prescription drug benefits, administered by Express Scripts. Express Scripts provides a nationwide retail pharmacy network, as well as its specialty pharmacy, Accredo. Express Scripts offers home delivery for maintenance medications that can help save you time and money. You may have to pay more if you get a brand name drug when a generic is available. Express Scripts’ preferred formulary list is available on myMCHCP or by calling Express Scripts.

Benefit Description HSA Plans PPO Plans
NetworkNon-Network NetworkNon-Network
Prescription Out-of-Pocket Maximum HSA Plans Combined with Medical PPO Plans
Network
$4,150/individual $8,300/family
PPO Plans
Non-Network
No Maximum for PE
Prescription Drugs Reduced costs for certain drugs and supplies. HSA Plans Preventive: MCHCP Pays 100%

Notes:
  1. Diabetic Drugs have reduced copayments (5%/10%/20%)
PPO Plans Preventive: MCHCP Pays 100%
Specialty: $100 through Accredo

Notes:
  1. Diabetic Drugs have reduced copayments ($7.50/$25/$60)
Specialty (Up to a 31-day Supply) HSA Plans -- PPO Plans
Plan Type Retail Network one-month (31-day supply) Retail Network two-month (60-day supply) Retail Network three-month (90-day supply) Home Delivery three-month (90-day supply) Retail Non-Network one-month (31-day supply)
HSA Plan
Coninsurance - after deductible is met
Generic Retail Network one-month (31-day supply) 10% up to $50 Retail Network two-month (60-day supply) 10% up to $100 Retail Network three-month (90-day supply) 10% up to $150 Home Delivery three-month (90-day supply) 10% up to $150 Retail Non-Network one-month (31-day supply) 40%
Preferred Retail Network one-month (31-day supply) 20% up to $100 Retail Network two-month (60-day supply) 20% up to $200 Retail Network three-month (90-day supply) 20% up to $300 Home Delivery three-month (90-day supply) 20% up to $300 Retail Non-Network one-month (31-day supply) 40%
Non-Preferred Retail Network one-month (31-day supply) 40% up to $200 Retail Network two-month (60-day supply) 40% up to $400 Retail Network three-month (90-day supply) 40% up to $600 Home Delivery three-month (90-day supply) 40% up to $600 Retail Non-Network one-month (31-day supply) 50%
PPO Plans
Copayment
Generic Retail Network one-month (31-day supply) $15 Retail Network two-month (60-day supply) $30 Retail Network three-month (90-day supply) $45 Home Delivery three-month (90-day supply) $37.50 Retail Non-Network one-month (31-day supply)
Preferred Retail Network one-month (31-day supply) $50 Retail Network two-month (60-day supply) $100 Retail Network three-month (90-day supply) $250 Home Delivery three-month (90-day supply) $125 Retail Non-Network one-month (31-day supply)
Non-Preferred Retail Network one-month (31-day supply) $120 Retail Network two-month (60-day supply) $240 Retail Network three-month (90-day supply) $360 Home Delivery three-month (90-day supply) $300 Retail Non-Network one-month (31-day supply)

Rx Savings Solution (RXSS)

Tired of paying more than you should at the pharmacy? Lower your prescription drug costs with MCHCP's vendor partner: Rx Savings Solutions (RxSS)!

How does it work?

Doctors know a lot, but they may not know what your prescriptions will cost. That's where RxSS comes in.

RxSS gives MCHCP health plan members with medical coverage the keys to taking charge of their prescription expenses by allowing them to compare medication prices quickly and easily. RxSS proactively alerts members when lower-cost prescription drug options become available, saving not only money, but time and energy, too!

If this all sounds a bit overwhelming, remember: This resource is as simple as 1, 2, 3!

  1. Review possible options for lower-cost medications (including generics, brands and equally effective prescription drugs that treat the same condition).
  2. Compare prices between different pharmacies.
  3. Switch to a lower-cost prescription with just one click.

And that's it! Pharmacy technicians from RxSS will work with your doctor to get the change approved, so you can begin saving money! (And, in some instances, you may even earn a cash reward for your savings efforts!)

Learn more about Rx Savings Solutions and access their services today by logging in to your myMCHCP account!

Members can also call RxSS at 800-268-4476 for more information.