Managed Limited Benefit Plan - Rx Prescription Cards

Fully Insured Prescription Benefit

• Generic Drugs - $15 co-pay, for a 30 day supply
• Preferred Brand Name Drugs* - $50 co-pay or 50% (whichever is greater), for a 30 day supply
• Non-Preferred Brand Name Drugs - Discount Only
• Monthly Maximum Limit $250 per month per insured person
• Over 2200 preferred brand drugs included on formulary listing

RxSelect Discount Prescription Benefit

The Discount Rx benefit is designed to save you money on your prescription drug costs by giving you
deep discounts on prescription drugs. To maximize savings, ask doctor or pharmacist to review your
RxSelect Product Guide and prescribe an appropriate drug within the lowest tier possible.

Tier 1  Select Brand & Generic Drugs:  You pay $10 or less
            for the scheduled quantity and dose at participating pharmacies

Tier 2  Select Brand & Generic Drugs:  You pay $25 or less
            for the scheduled quantity and dose at participating pharmacies

Tier 3  Select Brand & Generic Drugs:  You pay $50 or less
            for the scheduled quantity and dose at participating pharmacies

Tier 4  Non-Select Brands & Generics:: You pay 100% of the discounted price

RxSelect is not insurance or a Medicare Part D Prescription plan.

Nationwide Pharmacy Network and Mail Order Services
The USNow Rx retail pharmacy network consists of over 60,000 national, regional and local chains and independent pharmacies.  Both USNow Rx Plans offer fully integrated mail order services that provide members the convenience of home delivery only mail service can offer. Our network currently manages over 2 million members located in all 50 states.

Superior Customer Service
The USNow Rx Help Desk provides toll-free customer service eight hours a day/five days a week. The Help Desk is available to answer questions about your drug benefit plan, pharmacy network, and will provide pharmacy and eligibility assistance.

How to Use Your Prescription Drug Benefits
Select a convenient pharmacy in the USNow Pharmacy Network. Verify the pharmacy is still in the pharmacy network.

Pharmacy Network Some participating pharmacies include:
* Albertsons * Costco * CVS Pharmacy * Eckerd Drug * K Mart Pharmacy * Osco Drug * Phar-Mor * Publix Pharmacy	* Rite Aid Pharmacy * Safeway Pharmacy * The Medicine Shop * Target Pharmacy * Wal-Mart Pharmacy * Walgreens * Winn Dixie Pharmacy * And more..

 

*If a Brand Name Prescription Drug is dispensed in lieu of an available Generic Prescription Drug, then in addition to the Brand Co-payment, you will be responsible for the difference in cost between the Brand Name Prescription Drug and its Generic alternative. This information is a brief description of the important features of the insurance plan.  It is not a contract of insurance.  The terms and conditions of coverage are set forth in the policy issued in the state in which the policy was delivered. Complete details may be found in the policy. The policy is subject to the laws of the state in which it was issued.