Pharmacy Plan

Public Entity Members - Check with your employer to see which plans are available to you.

All medical coverage includes MCHCP’s prescription drug benefits, administered by Express Scripts. Express Scripts provides a nationwide retail pharmacy network, as well as its specialty pharmacy, Accredo. Express Scripts offers home delivery for maintenance medications that can help save you time and money. You may have to pay more if you get a brand name drug when a generic is available. Express Scripts’ preferred formulary list is available on myMCHCP or by calling Express Scripts.

Benefit Description	HSA Plans		PPO Plans
	Network	Non-Network	Network	Non-Network
Prescription Out-of-Pocket Maximum	Combined with Medical		$4,150/individual $8,300/family	No Maximum for PE
Prescription Drugs Reduced costs for certain drugs and supplies.	Preventive: MCHCP Pays 100% Notes: Diabetic Drugs have reduced copayments (5%/10%/20%)		Preventive: MCHCP Pays 100% Specialty: $100 through Accredo Notes: Diabetic Drugs have reduced copayments ($7.50/$25/$60)
Specialty (Up to a 31-day Supply)	--

Plan	Type	Retail Network one-month (31-day supply)	Retail Network two-month (60-day supply)	Retail Network three-month (90-day supply)	Home Delivery three-month (90-day supply)	Retail Non-Network one-month (31-day supply)
HSA Plan Coninsurance - after deductible is met	Generic	10% up to $50	10% up to $100	10% up to $150	10% up to $150	40%
	Preferred	20% up to $100	20% up to $200	20% up to $300	20% up to $300	40%
	Non-Preferred	40% up to $200	40% up to $400	40% up to $600	40% up to $600	50%
PPO Plans Copayment	Generic	$15	$30	$45	$37.50
	Preferred	$50	$100	$250	$125
	Non-Preferred	$120	$240	$360	$300

Rx Savings Solution (RXSS)

Tired of paying more than you should at the pharmacy? Lower your prescription drug costs with MCHCP's vendor partner: Rx Savings Solutions (RxSS)!

How does it work?

Doctors know a lot, but they may not know what your prescriptions will cost. That's where RxSS comes in.

RxSS gives MCHCP health plan members with medical coverage the keys to taking charge of their prescription expenses by allowing them to compare medication prices quickly and easily. RxSS proactively alerts members when lower-cost prescription drug options become available, saving not only money, but time and energy, too!

If this all sounds a bit overwhelming, remember: This resource is as simple as 1, 2, 3!

Review possible options for lower-cost medications (including generics, brands and equally effective prescription drugs that treat the same condition).
Compare prices between different pharmacies.
Switch to a lower-cost prescription with just one click.

And that's it! Pharmacy technicians from RxSS will work with your doctor to get the change approved, so you can begin saving money! (And, in some instances, you may even earn a cash reward for your savings efforts!)

Learn more about Rx Savings Solutions and access their services today by logging in to your myMCHCP account!

Members can also call RxSS at 800-268-4476 for more information.

Pharmacy Plan

Rx Savings Solution (RXSS)

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