Pharmacy

The cost and method for filling prescriptions varies based on the medical plan you’re enrolled in. Find your medical plan below for details.

With the Health Savings Plan (HSP), you can fill prescriptions at any retail pharmacy in the Premera network, including the on-campus Living Well Health Center pharmacy in Building 21 and the Commons Submixer. Find a Pharmacy here.

Important note: Some medications may be subject to prior authorization, step therapy, and/or quantity limits. See the Health Savings Plan Drug Formulary for a list of covered medications.

You can save money and receive up to a 90-day prescription supply delivered to your home or office by ordering your prescriptions through the Express Scripts mail order service. New mail orders typically arrive in 7-11 days; refills arrive in 3-5 days. To get started, go to Express Scripts. Contact Express Scripts with any questions at (800) 282-2881.

Benefit	In-network coverage	Out-of-network coverage
Preventive prescription drugs (see the HSP Preventive Drug List)	100%	100% of allowed amount
Prescription drugs, including brand-name (see the HSP Drug Formulary)	90% after deductible	90% after deductible (home delivery and specialty meds not available out of network)

Regardless of where you fill a prescription, you’ll pay when you pick it up (or when it’s mailed if you’re using mail order). The pharmacy has real-time access to your plan information and will charge you the negotiated Premera rate for your prescriptions. They also have information on the status of your annual deductible and coinsurance.

You’ll pay the full cost for your prescription medications until you meet your annual deductible. After you reach that amount, you’ll pay 10% of the cost of your prescriptions or other care, up to your coinsurance maximum.

With the Surest Health Plan, you can fill prescriptions at any retail pharmacy in the OptumRx network, including the on-campus Living Well Health Center Pharmacy in Building 21 and the Commons Submixer. To find an in-network pharmacy, go to the Surest member page.

Important note: Some medications may be subject to prior authorization, step therapy, and/or quantity limits. See the Surest Drug Formulary for a list of covered medications.

If you take medications on an ongoing basis, you can also use the mail-order option through Optum Home Delivery Pharmacy. New mail orders typically arrive in 7-11 days; refills arrive in 3-5 days. Contact Optum Home Delivery at (800) 356-3477 with any questions.

The Surest Health Plan prescription coverage is a three-tier prescription drug benefit; the copay varies depending on the tier in which your medication is located.

Benefit	In-network coverage	Out-of-network coverage
Preventive prescription drugs	100%	100%
Retail or Onsite Redmond Pharmacy	Generic (up to a 90-day supply): $10 copay Preferred brand (up to a 30-day supply): $50 copay Non-preferred brand (up to a 30-day supply): $90 copay	Generic (up to a 90-day supply): $10 copay Preferred brand (up to a 30-day supply): $50 copay Non preferred brand (up to a 30-day supply): $90 copay
Mail Order or Onsite Redmond Pharmacy (up to a 90-day supply)	Generic: $10 copay Preferred brand: $100 copay Non-preferred brand: $180 copay	Not applicable Not applicable Not applicable
Specialty Pharmacy (up to 30-day supply)	Generic: $10 copay Preferred brand $50 copay Non-preferred brand: $90 copay	Not applicable Not applicable Not applicable

With the Hawaii-Only Plan, you can fill prescriptions at any retail pharmacy in the Premera network. Find a Pharmacy here.

Important note: Some medications may be subject to prior authorization, step therapy, and/or quantity limits. See the Hawaii-Only Plan Drug Formulary for a list of covered medications.

Benefit	In-network coverage	Out-of-network coverage
Preventive prescription drugs (see the Hawaii-Only Plan Preventive Drug List)	100%	100% of allowed amount
Prescription drugs, including brand-name (see the Hawaii-Only Plan Drug Formulary)	90% after deductible	90% after deductible (home delivery and specialty meds not available out of network)

With the Kaiser HMO Plan for Washington, you must use an in-network pharmacy to fill prescriptions. The Living Well Health Center pharmacy in Building 21 and the Commons Submixer is considered an in-network pharmacy. Out of network pharmacies are not covered except for emergency services. Find a pharmacy here.

Important note: Some medications may be subject to prior authorization, step therapy, and/or quantity limits. See the Kaiser WA HMO Drug Formulary for a list of covered medications. Contact Kaiser at (206) 630-4636 or (888) 901-4636 with any questions.

Prescription (30-to-90-day supply)	Kaiser retail copay	Kaiser mail order copay
Preventive and value-based drugs	$0	$0
Preferred generic	$10	$5
Preferred brand	$25	$20
Non-preferred generic and brand	$50 ($35 max for insulin)	$45 ($35 max for insulin)

With the Kaiser HMO Plan for California, you must use an in-network pharmacy to fill prescriptions. Out of network pharmacies are not covered except for emergency services. Find a pharmacy here.

Important Note: Some medications may be subject to prior authorization, step therapy, and/or quantity limits. See the Kaiser CA HMO Drug Formulary for a list of covered medications. Contact Kaiser Permanente at (800) 464-4000 with any questions.

Prescription	Kaiser CA retail copay (up to 30-day supply)	Kaiser CA mail order copay (up to 100-day supply)
Preventive and value-based drugs	$0	$0
Preferred generic	$10	$20
Non-preferred generic and brand	$25	$50

Pharmacy

Learn more

Notice Regarding Reimbursement Checks from Evernorth/Express Scripts

Kaiser Permanente in California (HMO)

Kaiser Foundation Health Plan of Washington (HMO)

Hawaii-Only Plan

Surest Health Plan

Health Savings Plan (HSP)