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?
Shoppers
- If you're shopping Golden Rule Insurance Company plans, you can search for pharmacies or check drug coverage here.
- If you're in New Jersey shopping for Oxford Health Insurance ACA plans, you can search for pharmacies or check drug coverage here.
Members
Reference your ID card for your insurance company name and effective date.
If you're a Golden Rule member:
- Find pharmacy and drug coverage information here
- Register and manage your prescription benefits here
If you're an existing Oxford Health Insurance member in New Jersey:
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