Medical
Enroll

Prescription Drug Coverage

Contacts

Benefits Resource Center

888-857-0352

mlfbenefits@ajg.com

MLF Benefits Team

574-453-4133

rboyn@mapleleaffarms.com


Prescription drug costs

Prescription drug costs depend on your medical plan, the medication tier, and whether the medication is covered by the plan’s formulary. The Traditional Plan generally uses copays for many prescriptions. Under the HDHP, prescriptions generally apply to the deductible and coinsurance unless otherwise noted.

Common prescription terms

Formulary
A list of prescription drugs covered by the plan.

Generic medication
A medication with the same active ingredients, dosage, and strength as a brand-name medication. Generics usually cost less.

Preferred drug
A prescription drug preferred by the plan based on effectiveness and cost.

Prescription Drug Coverage

Prescription drug costs depend on your medical plan, the medication tier, and whether the medication is covered by the plan’s drug list, also called the formulary.

A tier is a pricing category. In general, lower-tier medications usually cost less, while higher-tier medications usually cost more.

Retail pharmacy — 30-day supply

The costs below apply to in-network retail pharmacy fills.

Why tiers matter

Two medications can treat the same condition but fall into different tiers. A generic medication may be lower cost, while a preferred brand, non-preferred medication, or specialty medication may cost more.

If your doctor prescribes a higher-tier medication, you may want to ask whether a lower-tier alternative is available.

Mail order and specialty medications

A 90-day mail order option may be available for certain prescriptions. Specialty medications may have separate rules or limits. Review Anthem’s formulary or contact Anthem before filling an expensive prescription.

Before filling an expensive prescription

Prescription costs can vary by plan, medication tier, pharmacy, and formulary status. Before filling an expensive prescription, check whether the medication is covered, what tier it is in, and whether a lower-cost alternative may be available.

Preventive medications

Some heart, cholesterol, blood pressure, diabetic, and other preventive medications and supplies may be covered at $0 cost.

Preventive medication categories may include:

Help & support

Need help?
This page is a general overview. Your exact benefits, costs, coverage start dates, and eligibility rules may depend on your employee group, plan election, coverage level, and pay frequency. It is your responsibility to review your benefits, coverage elections, and covered dependents. Review your official benefit guide or highlight document, confirm your elections in UKG, or contact the Benefit Resource Center for help.

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Benefits Department Contact

Regan Boyn

574-453-4133

rboyn@mapleleaffarms.com

Your exact benefit details may depend on your employee group. For payroll deductions, coverage start dates, HSA match amounts, and certain life/disability benefits, review the benefit guide or highlight document that applies to you.

Important: Payroll deductions vary by employee group and coverage level. Review your employee-specific benefit highlight or guide before making elections.

This website is intended for illustration and informational purposes only. The plan documents, insurance certificates and policies will serve as the governing documents to determine plan eligibility, benefits and payments. In the case of conflict between the information in this booklet and the official plan documents, the plan documents will always govern.