Check Drug Pricing

You can submit a test prescription to see what your estimated cost will be at the pharmacy you selected. You can also learn whether your drug is covered or if it requires a pre-authorization before you take your prescription to the pharmacy.

 

  1. Under Benefits & Coverage in the menu bar at the top of the page, click Check Drug Pricing. You can also click Check Drug Pricing in the Quick Links section to the right of the screen.
  2. Enter at least the first two characters in the name of the drug for which you are searching. A drop-down list of all drugs beginning with those characters displays.
  3. Select the drug you wish to view. A Drug Search pop-up window displays results for that drug name. For example, a drug may be listed as a 200mg capsule and a 250mg capsule. Whether a drug is brand or generic also displays, as well as the tier the drug is listed in, indicating whether it is preferred or non-preferred. If there is a generic drug available, it is listed in the Generic Equivalent column.
  4. Click the Select button next to the drug you wish to check the price of. If you select a brand when there is a generic equivalent available, you must explain why you selected the brand, as the pricing is generally affected. You either prefer the brand, in which case your co-payment will usually be increased by a product selection penalty fee, or your doctor prescribed the brand as “medically necessary," in which case penalties generally do not apply.
  5. The pharmacy displayed by default when you first view the Drug Pricing screen is the pharmacy through which you filled your last prescription, according to our records. To change this pharmacy to a different one, click Find and perform a pharmacy search (for more information, see Locate a Pharmacy). If you have not yet filled a prescription, you will first need to locate a pharmacy in order to price a drug. Click Select Mail Order Pharmacy to check the price of refilling via the mail order facility. The mail order facility's address will display.
  6. In the Quantity Of field, enter the number of units to be priced (for example, 30 tablets).
  7. Select the days' supply from the For Days Supply drop-down menu (for example, 30 days for a typical monthly prescription).
  8. Click Check Drug Price. Results display in a table. The drug name, whether it is a brand or a generic, any deductible, the copay amount, other costs, and total estimated member cost display.
  9. To check the price of another drug, perform another search as described above, and click Check Drug Price. When the new drug price results are displayed in the table, the deductible, copay, other costs, and total estimated member cost for it are added to the overall total.
  10. To clear the list and start a new drug list, click Clear / Start New Drug List.