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HPP Mail-Order Out-of-Pocket Maximum
You $2,000 You + family $4,000
HPP Retail Out-of-Pocket Maximum
You $2,000 You + family $4,000
HPP Mail Order Non-Preferred Brand Name Coinsurance
60% ($240 max/Rx)
HPP Retail Non-Preferred Brand Name Coinsurance
60% ($120 max/Rx)
HPP Mail Order Value-Based Non-Preferred Brand Name Coinsurance
80% ($120 max/Rx) Includes medication for high blood pressure, high […]
HPP Retail Value-Based Non-Preferred Brand Name Coinsurance
80% ($60 max/Rx) Includes medication for high blood pressure, high […]
HPP Mail Order Preferred Brand Name Coinsurance
80% ($200 max/Rx)
HPP Retail Preferred Brand Name Coinsurance
80% ($100 max/Rx)