Prescription Drugs
What You Need To Know About the Express Scripts Prescription Drug Programs
The Anthem Blue Cross PPO and EPO plan options are subject to the following prescription drug program provisions*:
Step Therapy
Step Therapy is a program to promote the use of lower cost but equally effective generic drugs before you "step up" to higher cost brand name drugs. Step therapy programs will change as they are added and deleted by Express Scripts.
Generics Preferred
Under the Generics Preferred program, prescriptions automatically will be filled with a chemically equivalent generic drug, if available and appropriate.
Exclusive Home Delivery
With Exclusive Home Delivery, members must obtain maintenance prescription drugs used to treat an ongoing medical condition through Express Scripts mail order service.
Prescription Drug Coverage in the EPO and PPO Plans under the Northrop Grumman Health Plan
Your cost varies depending on the type of prescription drug you purchase
| Type of Drug |
Network Retail Pharmacy
(up to 30-day supply) |
Mail Service Pharmacy
(up to 90-day supply) |
| Generic |
$5 copay or 10% coinsurance, whichever is greater |
$10 copay or 10% coinsurance, whichever is greater |
| Preferred Brand |
$20 copay or 10% coinsurance, whichever is greater |
$40 copay or 10% coinsurance, whichever is greater |
| Brand |
$40 copay or 10% coinsurance, whichever is greater |
$80 copay or 10% coinsurance, whichever is greater |
In the PPO plan, you can go to a non-network pharmacy and pay 50% of the eligible cost. (Non-network coverage is not available in the EPOs).
Maximum coinsurance of $200 per prescription per month for specialty drugs.
Coinsurance for specialty drugs will be 10%, up to a maximum of $200 per prescription.
*Does not apply to certain represented employees