Health Plans For California Federal Employees

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Anthem Blue Cross Select HMO

 

Anthem Blue Cross Select HMO provides more of what you want – more choices, more convenience, and more control. That’s a lot of more, with Anthem as your dedicated, dependable partner on your healthcare journey.

 

 With Anthem Blue Cross Select HMO:

 

You have to stay in network.

 

 

You’ll have predictable out-of-pocket costs.

 

 

There’s no annual deductible.

 

Pharmacy Benefits

 

Prescription Drug Copays For 2025

This table shows your monthly and yearly costs for prescription drugs in 2025. If you have any questions about your coverage, call the Member Services number on the back of your identification card.

Level 1 Retail Pharmacies

Item

30-Day Supply (Retail) Yearly Cost 30-Day Supply (Retail) 90-day Supply (Mail Order) Yearly Cost 90-Day Supply (Mail Order)
Tier 1

$10 copay

$120

$20 copay

$80

Tier 2

$50 copay

$600

$100 copay

$400

Tier 3

$80 copay

$960

$160 copay

$640

Tier 4

25% of our allowance ($250 maximum per prescription)

-

90-day supply is not available

90-day supply is not available

Level 2 Retail Pharmacies

Item

30-Day Supply (Retail) Yearly Cost 30-Day Supply (Retail) 90-day Supply (Mail Order) Yearly Cost 90-Day Supply (Mail Order)
Tier 1

$20 copay

$240

N/A

N/A

Tier 2

$60 copay

$720

N/A

N/A

Tier 3

$90 copay

$1,080

N/A

N/A

Tier 4

25% of our allowance ($250 maximum per prescription)

-

N/A

N/A

* Please note that pricing information is based on filling prescriptions at a Level 1 pharmacy. Add $10 to your copay if you’re having your prescriptions filled at a Level 2 pharmacy.