Health Plans For Colorado Federal Employees
BlueAdvantage HMO High Option
BlueAdvantage 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 BlueAdvantage HMO High Option:
You have to stay in network.
You’ll have predictable out-of-pocket costs.
There’s no annual deductible.
Pharmacy Benefits For BlueAdvantage HMO High Option
Prescription Drug Copays For 2022
This table shows costs for prescription drugs in 2022. 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 |
$5 copay after calendar year deductible |
$60 |
$10 copay |
$40 |
Tier 2 |
$60 copay |
$720 |
$150 copay |
$600 |
Tier 3 |
$80 copay |
$960 |
$200 copay |
$800 |
Tier 4 |
25% of our allowance ($275 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 |
$15 copay |
$180 |
N/A |
N/A |
Tier 2 |
$70 copay |
$840 |
N/A |
N/A |
Tier 3 |
$90 copay |
$1,080 |
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.
BlueAdvantage HMO HDHP
BlueAdvantage 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 BlueAdvantage HMO HDHP:
You have to stay in network.
You don’t need a referral for in-network providers.
You can have a health savings account (HSA) to help pay out-of-pocket costs.
Pharmacy Benefits For BlueAdvantage HMO HDHP
Prescription Drug Copays For 2022
This table shows costs for prescription drugs in 2022. If you have any questions about your coverage, call the Member Services number on the back of your identification card.
Level 1 Retail Pharmacies
| 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 after calendar year deductible |
$120 |
$20 copay copay after calendar year deductible |
$80 |
Tier 2 |
$40 copay after calendar year deductible |
$480 |
$100 copay copay after calendar year deductible |
$400 |
Tier 3 |
$70 copay after calendar year deductible |
$840 |
$175 copay copay after calendar year deductible |
$700 |
Tier 4 |
20% of our allowance after calendar year deductible ($300 maximum per prescription) |
- |
90-day supply is not available |
90-day supply is not available |
Level 2 Retail Pharmacies
| 30-Day Supply (Retail) | Yearly Cost 30-Day Supply (Retail) | 90-day Supply (Mail Order) | Yearly Cost 90-Day Supply (Mail Order) | |
|---|---|---|---|---|
Tier 1 |
$15 copay after calendar year deductible |
$180 |
N/A |
N/A |
Tier 2 |
$60 copay after calendar year deductible |
$720 |
N/A |
N/A |
Tier 3 |
$90 copay after calendar year deductible |
$1,080 |
N/A |
N/A |
Tier 4 |
25% of our allowance after calendar year deductible ($300 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.