Pharmacy benefit plans

Providence offers pharmacy benefit plans with different broad formulary options that supplement your client's Providence medical plans. Our pharmacy plans enable your clients to configure the level of coverage and cost-sharing that works best for your client's business and employees' health.

Plan features

All pharmacy plans include:

  • Preventive prescription medications covered in full on ACA preventive prescription medication
  • Access to more than 26,000 participating pharmacies
  • A 90-day supply of maintenance medications for two times the 30-day copay amount when purchased at a preferred retail or mail-order pharmacy
  • No separate out-of-pocket maximum
  • Care management for members with chronic conditions, including support for medication adherence, help identifying harmful drug interactions and help identifying opportunities to reduce health care costs

For more information on these products, formularies or participating pharmacies, see pharmacy resources.

To get a list of preventive medications Providence Health Plan covers without imposing a copayment, coinsurance or deductible, download the Affordable Care Act (ACA) list of preventive prescription medications (PDF).

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Pharmacy plan options

  • Rx 10/15/30/60/50
  • Rx 10/15/45/75/50
  • Rx 10/15/60/80/50
  • Rx 15/20/75/100/50
  • Rx 15/20/50/50/50
  • Rx 15/15/30/30/30
  • Rx 15/15/45/45/45

Pharmacy benefit plans

Drug Type  Preferred
Generic
Preferred
Non-Generic 
Preferred
Brand Name 
Preferred
Non-Brand Name
Specialty 
Rx 10/15/30/60/50 $10* $15* $30* $60* 50%*
up to $200
Rx 10/15/45/75/50 $10* $15* $45* $75* 50%*
up to $200
Rx 10/15/60/80/50 $10* $15* $60* $80* 50%*
up to $200
Rx 15/20/75/100/50 $15* $20* $75* $100* 50%*
Rx 15/20/50/50/50 $15* $20* 50%* 50%* 50%*
Rx 15/15/30/30/30 $15* $15* $30* $30* $30*
Rx 15/15/45/45/45 $15* $15* $45* $45* $45*

* Up to a 30-day supply purchased at a participating/preferred retail or specialty pharmacy
** Mail-order benefits are available on all pharmacy plans. A 90-day supply of maintenance medication is available for two times the 30-day copay amount when purchased at a preferred retail or preferred mail-order pharmacy.