Pharmacy Benefits | Office of Group Benefits

To find a pharmacy in the Caremark Network, please click this link: https://info.caremark.com/oe/ogb and scroll down to Find a Pharmacy in Your Area.

To check the cost of a prescription drug or if a drug is on the Caremark formulary, click the appropriate link below:

Active employees/non-Medicare retirees: https://info.caremark.com/oe/ogb
Medicare retirees: https://info.caremark.com/oe/ogbmedicarerx

PHARMACY BENEFITS – PELICAN HRA1000 & MAGNOLIA PLANS

These plans use the CVS Caremark formulary. The formulary is reviewed regularly to reassess drug tiers based on the current prescription drug market. Members will continue to pay a portion of the cost of their prescriptions in the form of a co-pay or coinsurance. The amount members pay toward their prescription depends on whether or not they receive a generic, preferred brand, non-preferred brand or specialty drug.

Tier	Member Co-Pay*
Generic	50% up to $30
Preferred	50% up to $55
Non-Preferred	65% up to $80
Specialty	50% up to $80
Once you pay $1,500:
Generic	$0
Preferred	$20
Non-Preferred	$40
Specialty	$40

*Member responsibility is for a prescription drug benefit of up to a 31-day supply.

PHARMACY BENEFITS – PELICAN HSA775

Blue Cross and Blue Shield of Louisiana works in partnership with Express Scripts® to administer your prescription formulary drug program for the Pelican HSA775. Prescriptions are subject to the plan deductible with the exception of maintenance medications.

Tier	Member Co-Pay*
Generic	$10
Preferred	$25
Non-Preferred	$50
Specialty	$50
*Subject to deductible and applicable co-payment. Maintenance drugs are not subject to the deductible.