Your Prescriptions, Made Easy
No matter which medical plan you choose, you’ll enjoy prescription drug coverage through AdventHealth Rx Plus Pharmacy, in partnership with CVS Caremark.
Rx Plus Pharmacy is a member resource that helps you get your maintenance medications delivered right to your door. It's just another way we care for you in body, mind and spirit.
Prescription Drug Coverage Details
Retail*(Up to a 30-day supply) | AdventHealth Rx Plus Pharmacy(Up to a 90-day supply) | |
|---|---|---|
If you enroll in the Health Savings Plan, you must first meet a combined medical and | ||
Generic (Tier 1) | You pay up to $10 | You pay up to $10 |
Formulary (Tier 2) | You pay 20% of the cost | You pay 20% of the cost |
Non-Formulary (Tier 3) | You pay 20% of the cost | You pay 20% of the cost |
Specialty (Tier 4) | N/A | You pay 20% of the cost |
* Maintenance medication coverage is limited to one 30-day grace fill at local, then 90-day supplies filled by AdventHealth Rx Plus Pharmacy.
** Certain specialty medications may be subject to a 90-day dispensing requirement and cost shares. The Specialty Pharmacy Team will work with members as needed.
Managing Your Prescriptions
- Take Advantage of Rx Plus Pharmacy
-
Your AdventHealth Rx Plus Pharmacy is here to make life easier. Our top priority is to ensure your prescriptions are filled safely, quickly and delivered right to your door — so you and your loved ones feel cared for.
Here’s what you can expect:
- Fast turnaround times for prescriptions
- A dedicated team ready to answer questions and provide support
- Convenient access through MyChart: Rx Plus Pharmacy is part of the Epic platform, so you can manage prescriptions in the same AdventHealth MyChart portal you already use for your care
Important: For maintenance medications, you’ll have one 30-day grace fill at a local pharmacy. After that, 90-day supplies must be filled through AdventHealth Rx Plus Pharmacy.
Don't forget: If you move or your mailing address changes, be sure to update your address directly with AdventHealth Rx Plus Pharmacy. Address changes made in Workday are not automatically sent to Rx Plus, so updating your address with the pharmacy helps ensure your medications are delivered to the right location.
- Save Money on Prescriptions
-
Want to cut costs on your medications? Here’s how:
- Ask for generics whenever possible — they’re just as effective and cost less.
- Use AdventHealth Rx Plus Pharmacy for convenient mail-order delivery of medications you take regularly.
- Health Savings Plan Members, Take Note
-
If you choose the Health Savings Plan, understanding how prescription coverage works will help you avoid surprises and make the most of your benefits.
One Deductible for Medical and Prescriptions
If you enroll in the Health Savings Plan, your medical and prescription costs share the same annual deductible. Here’s what that means for you:
- Before you meet your deductible: You pay the full cost of medical care and prescriptions.
- After you meet your deductible: You pay a fixed copay for medications based on the drug tier.
- Copays count toward your out-of-pocket maximum: Once you reach that maximum, eligible prescriptions are $0 for the rest of the plan year.
Preventive Drug List
Good news! Medications on the preventive drug list aren’t subject to the deductible and follow the regular copay structure. See the full list here.
Copay Assistance
Health Savings Plans follow IRS rules, which means you must meet your deductible before manufacturer copay assistance can be applied. Copay cards can help lower what you pay at the pharmacy, but those savings don’t count toward your deductible or out‑of‑pocket maximum.
Prescription Drug Coverage
-
Generic (Tier 1)
Low-cost generic drugs are at the lowest copay level.
-
Formulary (Tier 2)
These are primarily brand-name drugs that have been determined to be more effective, less costly or to have fewer side effects than similar medications.
-
Non-Formulary (Tier 3)
These are mostly high-cost brand-name drugs with lower cost generic and/or brand alternatives. These drugs have been selected by the plan based on review of the relative safety, effectiveness and cost of the many brand-name drugs on the market.
-
Specialty (Tier 4)
These medications treat complex conditions and require extra care. Specialty medications are filled through the Specialty Pharmacy Program by AdventHealth Rx Plus and Expedien Pharmacy, providing a high-touch, patient-centered service and positive experience for our members.
This site summarizes the programs and benefits available to team members and their eligible dependents. Official plan documents, policies and certificates of insurance that contain the details, conditions, maximum benefit levels and restrictions on benefits govern our benefits program. In case of a conflict between this site and the official documents, the official documents prevail. The information on this site isn't a guarantee of benefits. AdventHealth reserves the right to modify or terminate its employee benefit plans and programs at any time for any reason.