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Access to affordable prescription drugs is just as important as the ability to choose your own doctor. That's why many of our health insurance plans include a prescription drug benefit. These prescription drug benefits vary depending on the type of health plan you choose.

Pharmacy Benefit Basics

When considering a health insurance plan and out-of-pocket costs for prescription drugs, you should know about:

  • Tier Pricing: (Copay plans only.) Each medication is placed in a tier, a numbered level. There is a set copay for drugs in each tier.
  • Deductible: With some of our plans prescription drugs count toward the plan deductible. Once you meet the deductible, the plan starts paying for covered expenses, including prescription drugs.
  • Coinsurance: For lower premiums, some plans include a coinsurance amount (a percentage of the cost you pay) for drugs once the plan deductible is satisfied.
  • Mental Health: Prescription drugs for mental disorders or substance abuse are not covered unless mental disorders and substance abuse is a covered benefit on your plan. This includes prescription drugs for ADD, ADHD, anxiety, depression and others.

Looking for Pharmacies or Drug Coverage Information?

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Reference your ID card for your insurance company name and effective date.

If you're a Golden Rule member:

If you're an existing Oxford Health Insurance member in New Jersey:

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