Prescription Drugs

The HMSA PPO and Kaiser Permanente HMO plans include prescription drug coverage.

HMSA PPO plan

The prescription drug benefit—administered by CVS/Caremark—covers a long list of FDA-approved drugs. To be covered, prescriptions must be ordered by a doctor and filled/refilled within one year of the original prescription date (or as permitted by law). To see which drugs are covered under this plan, download the HMSA Drug Formulary Master List.

How it works

Present your prescription drug ID card at a participating CVS/Caremark retail pharmacy or give the information on your ID card to the CVS/Caremark mail order service, and you’ll pay the prices below. To find a participating pharmacy, call 800-776-4672.

Kaiser Permanente HMO plan

The prescription drug program benefit covers a comprehensive list of FDA-approved drugs. Prescriptions must be ordered by a doctor and may be refilled within one year of the original prescription date, as permitted by law. Any limitations that apply to an original prescription also apply to the refills. Copayments will vary based on drug type. See what drugs are included.

How it works

Present your prescription to your Kaiser pharmacist or use the mail order service.

What you pay

Retail Pharmacy
30-Day Supply
Mail Order
Up to a 90-Day Supply
HMSA PPO Kaiser HMO HMSA PPO Kaiser HMO
Generic drugs $7 copayment $10 copayment $11 copayment $20 copayment
Preferred brand-name drugs $30 copayment $45 copayment $65 copayment $90 copayment
Nonpreferred brand-name drugs $30 copayment $45 copayment $65 copayment $90 copayment

For more information about prescription drug costs, download the HMSA or Kaiser Summary of Benefits and Coverage.

Save money on prescriptions

  • Mail order. To help you save on maintenance medications (drugs you take for ongoing conditions, such as high blood pressure, asthma, or allergies), both plans include a mail order feature. You’ll pay less and your medication is mailed to your home.
  • Ask for generics. If you're taking a brand-name drug, talk to your doctor and ask if a generic drug could treat your condition. FDA-approved generics are as safe and effective as their brand-name counterparts; they just cost less because more than one company can manufacture them. If your doctor agrees a generic drug is right for you, ask for a new prescription for the generic drug.