Rx Choice Tiered Pharmacy Network: An easy way to find level 1 pharmacies
Earlier this year, we announced that we’re offering a new focused pharmacy network option, called the Rx Choice Tiered Network, to members in our Individual, non-standard plans sold off Covered California (also called the exchange). The new Rx Choice Tiered Network has been available since January 1, 2017. And we’ve made it easy to help your clients find local pharmacies where they will pay a lower cost-share amount.
The California Individual plans with the Rx Choice Tiered network include:
• Bronze Pathway EPO 5250 (2EUZ)
• Bronze Pathway EPO 5850 (2EV1)
• Bronze Pathway EPO 6900 (2EV0)
• Silver Pathway EPO 1900 (2EV3)
• Silver Pathway EPO 2000 (2EV2)
• Silver Pathway HMO 2650 (2EVC)
• Bronze Pathway PPO 5250 (2JYD)
• Bronze Pathway PPO 5850 (2JYG)
• Bronze Pathway PPO 6900 (2JYH)
• Silver Pathway PPO 1900 (2JYF)
• Silver Pathway PPO 2000 (2JYE)
The Rx Choice Tiered Network offers two levels:
• Level 1 – Nearly 25,000 retail pharmacies participate in the core level 1 network. Members will pay a lower cost share compared to a level 2 pharmacy.
• Level 2 – Retail pharmacies on level 2 of the network make up the remaining locations (about 45,000 pharmacies). Members who choose retail pharmacies on level 2 will pay a level 2 cost share, which has a higher copay/coinsurance and/or a maximum amount per prescription than level 1.
To make it easier than ever to find local level 1 pharmacies, refer to this Rx Choice Tiered Pharmacy list for California. A circle with either a 1 or a 2 next to each pharmacy indicates whether it’s a level 1 or a level 2.