Actives Medical &
RX Information Open Access Managed Choice POS
IN NETWORK BENEFITS SNAPSHOT
Pharmacy Benefits - KrogerPreferred Generic Drugs:
$20 copay Retail, $40 Mail Preferred Brand-Name Drugs:
$50 copay Retail, $100 copay Mail Non-Preferred Generic and Brand-Name Drugs:
$100 copay Retail, $200 copay Mail Specialty Drugs: 30% Maximum $350 Preferred, 30% Maximum $350 Non-Preferred |
Questions? Call Narus. 888-585-3309
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* See full benefit summaries for details, exclusions, out of network co-pays, & other coverage. Covered expenses only. This web site is not a legal document. This web site is not a guarantee of coverage, eligibility, or provider status and is designed for informational illustration only. Benefits outlined on this web site are subject to change at any time. Please consult your benefit plan provider(s) or administrator(s) for legal documents regarding your plan and to check coverage and/or eligibility