Medicare Supplement prescription drug coverage

The Medicare Supplement prescription drug program is a qualified Medicare Part D program. As such, it uses a different drug formulary than your medical coverage through the Board of Pensions before you retired.

New for 2021: On January 1, 2021, Express Scripts will administer the prescription drug program. Plan benefits and features remain the same. Only the administration will change. Learn more about the move to Express Scripts.

If you have not yet received your welcome package from Express Scripts with your new ID card, call Express Scripts at 877-856-4694 to request a new card. You can also download and print an ID card by logging on to the Express Scripts website, or you can use the Express Scripts mobile app to access a virtual ID card.  

You pay a share of the cost for covered drugs — your copayment — until your out-of-pocket prescription drug costs reach the annual copayment maximum. Then, the plan pays 100 percent of your costs for eligible generic and formulary drugs for the rest of the year. Under Medicare Supplement each participant has a separate copayment maximum.

How much you pay for covered drugs

Your copayment amounts vary depending on the type of drug and whether you fill prescriptions at a retail pharmacy or through the mail-order service.

​Type of pharmacy​Maximum fill​Your cost per prescription for generic drug*​​Your cost per prescription for formulary drug*​​Your cost per prescription for non-formulary drug*
​Retail pharmacyUp to 30-day supply​​$10
​30% of drug cost
min. $20 to max $100
​50% of drug cost
min. $50 to max $150
​Retail pharmacy​Up to 90-day supply​$30
​30% of drug cost
min. $60 to max $300
​50% of drug cost
min. $150 to max $450
​Mail-order serviceUp to 90-day supply​​$25
​30% of drug cost
min. $50 to max $250
​50% of drug cost
min. $125 to max $375
​Annual copayment maximum​n/a
The maximum amount you pay each year in out-of-pocket prescription drug costs is ​$2,500 per participant
Any costs for non-formulary drugs do not count toward your annual copayment maximum.