Pharmacy Benefits

No matter which plan you choose, you’ll have access to the Capital Rx Prescription Drug Program, which includes more than 69,000 pharmacies nationwide, 30-day retail and 90-day maintenance medication coverage, mail-order and specialty delivery through Costco, and 24/7 pharmacist support.

What are Prescription Tiers?

Prescription tiers are part of your pharmacy benefits. Understanding what each tier covers can help you save on pharmacy costs.

These medications are generics. These are fully equivalent to brand name medications, but without the brand name price tag.

These medications are brand name, but may not have a generic equivalent yet. These preferred brand names come at a lower price than non-preferred, but are not as low cost as generics.

These medications are brand name and non-preferred. These usually have a preferred equivalent, but they are still covered. The cost for these will vary up to a maximum of $50 for the Platinum plan and up to $60 for the Gold plan.

These medications are highly specialized medications for specific conditions. These medications are often very expensive, but your plan only charges a flat copay per fill.
Capital Rx Platinum Plan Gold Plan
Rx Out of Pocket Maximum

$1,500 Individual

$3,000 Family

$1,500 individual

$3,000 family
Tier 1 (Generic) $5 Copay $10 copay
Tier 2 (Preferred) $15 Copay $20 copay
Tier 3 (Non-Preferred) 50% with $30 Min. / $50 Max $50% with $40 minimum/$60 Max
Specialty $100 copay $150 copay