Find the Exact Cost of Your Drugs

Find out the cost of a medication before you get to pharmacy by using the Drug Cost Preview tool:

  1. Go to Navitus ETF Benefits website.
  2. Select your health plan design.
  3. Select Drug Cost Preview in the left menu.

You can also compare the cost of your drugs at multiple pharmacies to find the best price. See the Navitus Member Portal Guide to learn more.

Breakdown of Your Pharmacy Costs

Each covered prescription drug falls into one of four cost-sharing levels. The lower the level, the less you pay. The table below shows how much you will pay for drugs in each level and the maximum amount you will pay for covered drugs each year.

You must fill your prescriptions at an in-network pharmacy. Find an in-network pharmacy. In-network pharmacies are available nationwide. 

 

IYC Health Plan & Access Plan

 High Deductible Health Plan (HDHP) & Access HDHP

Prescription Deductible

Individual / Family

None

Combined medical & pharmacy:

$1,500 / $3,000

You pay 100% of most pharmacy costs until deductible is met.1

Prescription Copay / Coinsurance

Level 1

 

$5 or less

 

After deductible: Up to $5

Level 2

20% ($50 max)

After deductible: 20% ($50 max)

Level 3 

40% ($150 max)2

Level 3 “Dispense as Written” or “DAW-1” drugs may cost more. 

After deductible: 40% ($150 max)2

Level 3 “Dispense as Written” or “DAW-1” drugs may cost more. 

Level 4

$50 copay3

Must fill at Lumicera Health Services specialty pharmacy or UW Specialty Pharmacies.

After deductible: $50 copay3

Must fill at Lumicera Health Services specialty pharmacy or UW Specialty Pharmacies.

Preventive prescriptions

$0- Plan pays 100%, regardless of deductible, as federally required

$0- Plan pays 100%, regardless of deductible, as federally required

Prescription Out-Of-Pocket Limit

Levels 1 & 2 

Individual / Family

 

$600 / $1,200

Combined medical & pharmacy: 

$2,500 / $5,000

Level 3 & 4

Individual / Family

$8,700 / $17,400

Combined medical & pharmacy: 

$2,500 / $5,000

1 Before you meet your deductible, preventive drugs are covered 100% and certain maintenance medications only require a copayment or coinsurance.

2 For Level 3 “Dispense as Written” or “DAW-1” drugs, your doctor must submit a one-time FDA MedWatch form to Navitus. If there is no form on file with Navitus, you will pay more. Contact Navitus at 1-866-333-2757 for details.

3 Must fill at Lumicera Health Services specialty pharmacy or UW Health Specialty Pharmacies.