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Prescription Drug Coverage

Prescription drug coverage is included in your medical plan. The State of Idaho health plan utilizes a customized six-tier drug list or formulary. The best way to search for covered medications is to search the Regence 6-Tier Drug List (see Pharmacy Information sidebar). You can also access an up-to-date, searchable database of medications and treatments when you log into the member portal at Regence.com. For more details about the prescription drug plan, including copayment explanations, exclusions, limitations and how the plan works, please see the Summary of Benefits & Coverage and/or the plan Contract (see Medical Plans page).

PPO and Traditional Plans

Formulary TierCopay
Tier 1 - Preferred Generics (typically the least costly at the pharmacy)$10
Tier 2 - Generics and some lower-cost brand products$10
Tier 3 - Preferred brand-name drugs that are typically less costly$30
Tier 4 - Typically high-cost brand-name drugs$60
Tier 5 - Preferred specialty medications; may include lower-cost brand or generic specialty medications$60

Tier 6 - Higher-cost specialty medications; may include higher-cost brand or generic specialty medications
$100

 



HDHP Plan

The HDHP plan has a 20% coinsurance for all six tiers without copays. The costs for all prescriptions not listed on the Optimum Value Medication List (see Pharmacy Information sidebar) are subject to the HDHP deductible. Benefits will not begin until the deductible is met on the HDHP plan.

 



Specialty Medications from Accredo

Regence Blue Shield of Idaho partners with Accredo (1-833-599-0514) to offer medication and support for members managing complex health issues. Members will also have the option to fill specialty medications at AllianceRx Walgreens Pharmacy.


Convenient home delivery with Amazon MedsYourWay

Save money and time when you use Amazon Pharmacy with the MedsYourWay discount. Take advantage of home delivery for covered maintenance medications, preventive prescriptions and over-the-counter medications. With Amazon Home Delivery, you can expect:

    • Up to 90-day refills at a time
    • Free 5-day shipping; 2-day for Amazon Prime members
    • Discreet packaging
    • 24/7/365 access to pharmacists
    • Ability to use your health savings account dollars

Visit Amazon.com/regenceIDMYW and use the information on your Regence member ID card to get started. 

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