Any questions about your pharmacy benefit can be answered by calling Member Services. Just call the number on the back of your member ID card.
Lowest-cost prescription generic and some over-the-counter drugs.
Prescription generic and some over-the-counter drugs.
Brand-name drugs that don't have a generic available. Also may include higher priced generics that have more cost-effective options at lower tiers.
Brand-name drugs that have brand or generic options at lower tiers. Also may include higher-priced generics that have more cost-effective options at lower tiers.
Specialty drugs* that are more cost-effective than other specialty drugs that treat the same conditions. Also may include some non-specialty brand or generic drugs that have more cost-effective options at lower tiers.
Specialty drugs that have more cost-effective alternatives at Tier 5. Also, may include some non-specialty brand or generic drugs that have more cost-effective options at lower tiers.
*Specialty drugs are prescription medications that are used to treat complex or chronic medical conditions, such as cancer, rheumatoid arthritis, multiple sclerosis and hepatitis C.
Please note that if a plan has a brand deductible, any tier 3 or tier 4 medication will process to that deductible before applying benefits.
Effective immediately, you can get your seasonal flu vaccine covered at $0 copay through your pharmacy benefit by visiting any network pharmacy. Find a participating pharmacy with our Pharmacy Locator, or you can visit your primary care physician. Don't have a primary care physician? Find one here.
You can also visit a participating pharmacy within South Carolina or the entire U.S. to get some non-seasonal preventive care vaccines at $0 copay. A chart of these vaccines is as follows:
HAEMOPHILUS B POLYSAC CONJ-HEPATITIS B (RECOMB) VACCINES
HEPATITIS A (INACTIVATED)-HEPATITIS B (RECOMBINANT) VACCINE
HEPATITIS A VACCINE
HEPATITIS B VACCINE
HEPATITIS B VACCINE RECOMB ADJUVANTED PREF SYR 20 MCG/0.5ML
HEPATITIS B VACCINE RECOMBINANT ADJUVANTED 20 MCG/0.5ML
HUMAN PAPILLOMAVIRUS (HPV)
MENINGOCOCCAL (C & Y)-HAEMOPHILUS B TETANUS TOX CONJ VACCIN