Option 1
- $500 annual prescription deductible for brand/specialty only
- $0 Generic for 30 or 90 Day, deductible waived
- $100 after deductible Preferred Brand
- $175 after deductible Preferred Brand
- Lesser of $1,500 or 25% after deductible for Specialty Meds
 
Option 2
- $500 annual prescription deductible for brand/specialty only
- $0 Generic for 30 or 90 Day, deductible waived
- $100 after deductible Preferred Brand
- $175 after deductible Preferred Brand
- Lesser of $1,500 or 25% after deductible for Specialty Meds
 
Option 3 – HSA
- $1,700 Individual / $3,400 Family
- $0 Generic Copay after deductible
- 25% after deductible Preferred Brand
- 25% after deductible Preferred Brand
- 25% after deductible for Specialty Meds
Lucy RX
Customer Service: 877-860-8846


