Anthem pharmacy benefits are managed by Optum Rx. You can see which drugs are covered on the Optum premium drug list. Optum Specialty Pharmacy provides specialty medications and clinical support for complex conditions like cancer and MS. To learn more, call 877-838-2907.
For in-network prescription drugs with the Anthem PPO 1000, you pay $15 for generic drugs, $30 for preferred brand-name drugs, and $60 for nonpreferred brand-name and specialty drugs. Prescription costs do not count toward your deductible.
With the Anthem PPO HSA 1700 or Anthem PPO HRA 3500, you pay the market price of prescriptions until you meet your deductible, and these prescription costs count toward your deductible. For in-network prescription drugs after you meet your deductible, you pay $15 for generic drugs, $30 for preferred brand-name drugs, and $60 for nonpreferred brand-name and specialty drugs.
With the PPO 6350 for interns, you pay $0 for prescriptions after you meet your deductible.
Flu Shot and routine vaccination coverage: Please note that routine vaccinations and flu shots are covered by Optum when administered in a pharmacy setting. If you receive your flu shot at a physician’s office or other medical setting, it will be covered under your Anthem plan. Be sure to check your coverage details before scheduling. Find participating pharmacy’s and program details for Optum.
