Medicamento recetado
All Johns Hopkins medical plans include prescription drug coverage.
Prescription drug coverage is automatically included when you enroll in a Johns Hopkins medical plan. You don’t need to enroll in prescription drug coverage separately.
All Johns Hopkins Employer Health Programs (EHP) medical plans administer prescription drug coverage through CVS Caremark.
Si eres un Empleado de Suburban Hospital enrolled in the Kaiser HMO Plan, your prescription drug coverage is managed by Kaiser.
Understanding your prescription drug coverage
Drug tiers
- Generic: Affordable and effective alternative to a brand name drug, typically the lowest cost option.
- Preferred brand drugs: Typically cost more than generics but less than other brand-name drugs because of their preferred status due to their clinical value and cost-effectiveness.
- Nonpreferred and brand name drugs: Cost more than a preferred brand drug would because of their non-preferred status.
- Specialty: Expensive drugs used to treat complex, chronic or rare medical conditions. Typically, these can only be filled by a specialty pharmacy.
Retail vs. Mail Order
Typically, retail pharmacies are used for filling 30-day prescriptions. However, you may be able to order a 90-day supply of maintenance medications at a retail pharmacy or through mail order.
The advantage to using mail order for 90-day prescriptions is convenience—your prescription is delivered to your door with an auto-refill option.
What you pay for prescription drugs
The costs in the charts below apply after the deductible, unless noted otherwise. The amount you pay depends on the tier of drug and quantity of the fill.
All our medical plans offer no-cost programs for specialty, asthma and diabetes medications.
Contactos
CVS Caremark
888-543-4921
caremark.com
Kaiser HMO
(Suburban Hospital only)
301-468-6000
healthy.kaiserpermanente.org
Resources
Cost for a 30-day supply
| EPO de Johns Hopkins | Johns Hopkins PPO | Johns Hopkins DPC (Maryland only) | Kaiser HMO (Suburban only) |
|
|---|---|---|---|---|
| Generic | $10 copay | $10 copay | $10 copay | $10 copay |
| Preferred | You pay 25%; min $40, max $60 | $40 copay | $40 copay | $30 copay |
| Brand1 & Non-Preferred | You pay 50%; min $65, max $105 | $65 copay | $65 copay | $50 copay |
| Specialty | You pay 30%, or $0 if enrolled in PrudentRx | You pay 30%, or $0 if enrolled in PrudentRx | You pay 30%, or $0 if enrolled in PrudentRx | Applicable copay for generic, preferred, brand & non-preferred |
Cost for a 90-day supply
| EPO de Johns Hopkins | Johns Hopkins PPO | Johns Hopkins DPC (Maryland only) | Kaiser HMO (Suburban only) |
|
|---|---|---|---|---|
| Generic | $30 copay | Retail: $30 copay Mail order: $20 copay |
Retail: $30 copay Mail order: $20 copay |
$20 copay |
| Preferred | You pay 25%; min $120, max $180 | Retail: $120 copay Mail order: $80 copay |
Retail: $120 copay Mail order: $80 copay |
$60 copay |
| Brand1 & Non-Preferred | You pay 50%; min $195, max $315 | Retail: $195 copay Mail order: $130 copay |
Retail: $195 copay Mail order: $130 copay |
$100 copay |
| Specialty | No cubierto | No cubierto | No cubierto | Applicable copay for generic, preferred, brand & non-preferred |
1 If you choose a brand name drug when there’s a generic alternative, you’ll also pay the cost difference between the two.
No-cost programs for specialty, asthma and diabetes medications
No-Pay Copay for asthma & diabetes medications
The No-Pay Copay benefit will waive the copay for most asthma and diabetes medications if you’re enrolled in the EHP Care Management program.
In each program, you’ll work one-on-one to:
- Evaluate your wellness and personal needs
- Coordinate your health care
- Improve self-management of your condition
To learn more and enroll, contact EHP at 800-557-6916 or [email protected] .
PrudentRx Specialty Medication Program
You can get certain specialty medications at no cost through the PrudentRx program. Prescriptions must be filled at a CVS Specialty Pharmacy or Publix.
View the current list of eligible medications under the PrudentRx program on the EHP website . This list is updated monthly, so please check it regularly for any changes.
You’re automatically enrolled in the PrudentRx program if you take any eligible medications. If you choose to opt out of the program, you’ll pay 30% coinsurance (after the deductible) for your medication. View the FAQs for more information.
Note: If you contributed a certain amount to your health care flexible spending account (FSA) based on your specialty medication’s eligibility, and the medication is added or dropped from the list, you’ll be allowed to make changes to your health care FSA election.