Prescription Benefit Plan Information

Prescription Benefit Plan Information

The following is specific information for Baylor University prescription drug program, administered by CVS/caremark. This benefit is included with enrollment in the Baylor University group medical plans.

PPO Blue Choice Copays When Using Retail Pharmacies

Generic - $10 per 30-day supply
Preferred brand-name - $35 per 30-day supply
Non-preferred brand-name - $60 per 30-day supply

Specialty prescriptions filled with CVS Specialty only - $95 limit 30-day supply

Note: You are under a mandatory generic plan for prescriptions. Dispense as Written (DAW) 2 rules apply. If you or your doctor choose the brand-name drug over the generic alternative, you will be responsible for your plan designated copay* and possibly an additional fee as determined by your plan.

PPO Blue Choice Copays When Using Mail Service

Generic - $25 per 90-day supply
Preferred brand-name - $87.50 per 90-day supply
Non-preferred brand-name - $150 per 90-day supply

HDHP + HSA

Annual Deductible:
Individual Only: $1,500
Family: $3,000

If you have family coverage, you will be required to satisfy the Family Deductible before receiving medical or prescription coverage for any member of your family.

Once deductible has been met:
Co-Insurance:
Plan pays 80% for generic and 70% for brand-name of prescription costs

Other Potential Costs for Both Plans:
  • You are under a mandatory generic plan for prescriptions. Dispense as Written (DAW) 2 rules apply. If you or your doctor choose the brand-name drug over the generic alternative, you will be responsible for payment designated by the plan and possibly an additional fee based on drug cost.
  • You may be responsible for full charges if a drug is excluded on the formulary. To view the CVS/Caremark Prescription Exclusion list, click here.
  • You may be responsible for full charges if a drug is on the Step Therapy list. Please review the Step Therapy Program information. You may review the Step Therapy drug list here.
Other Potential Savings Outside of Baylor's Plan:

While Baylor provides an excellent benefit, a simple internet search may help identify ways you as a consumer can save more with certain drug discount programs. Your doctor may also be able to assist you in this way. Baylor does not endorse the following programs, but provides them as a starting place for you to look further: