Prescription Drug Coverage
Expanded Preventive Generic
Expanded Preventive Preferred Brand
Generic
Preferred Brand
Non-Preferred Brand
Specialty
|
$10 Copay
$25 Copay
$10 Copay
$25 Copay
50%
$200 Copay
|
$20 Copay
$50 Copay
$20 Copay
$50 Copay
50%
Not Available
|