Tools and Resources


Prescription drug coverage is administered through CVS/caremark. To determine your coverage tier or cost, call 866-601-6935.


A maintenance drug is one that is commonly used to treat a chronic or long-term condition and requires regular, daily use. Examples include drugs used to treat high blood pressure, heart disease, asthma and diabetes. Birth control is also considered a maintenance drug. For a complete list of maintenance drugs, click here.

If you currently have a prescription for a maintenance drug, you will need to have a prescription for a 90-day supply (not a 30-day supply) AND you will need to fill your prescription in one of three ways:

IMPORTANT: If you don’t use a 90-day prescription and try to get a 30-day prescription filled at a retail location other than one of the methods above, you will be charged the full retail cost (not the co-pay amount).


With Tier Zero, generic prescription medications used to treat chronic health conditions such as congestive heart failure (CHF), diabetes, high blood pressure, high cholesterol, tobacco addiction and more, are covered at 100%. For Tier Zero medications you pay $0 for a 30- or 90-day supply.

To determine your coverage tier or cost, visit call CVS/caremark at 866-601-6935.


If you are enrolled in the HSA Plan, you must pay all out-of-pocket costs for prescription drugs until you meet your annual deductible (with the exception of Tier Zero drugs; Emory pays 100% and plan participants will pay $0 for drugs that are listed as Tier Zero).

For non-Tier Zero drugs, you can use your HSA to pay for your prescription drug costs. After you meet the deductible, you will pay the applicable co-insurance amount under the HSA Plan, up to the "30-day Retail Maximum." The table below shows what your responsibility is once your deductible is satisfied. For example, if the table shows co-insurance is 20%, the plan will pay 80% of the cost of the prescription drug and you are responsible for the other 20%. However, there is financial protection built into the prescription drug benefit in that you will never pay more than the "30-day Retail Maximum," outlined in the table below:

HSA prescription tiers

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Prescription drug coverage is part of your medical plan and you pay a percentage of the cost though coinsurance. There is also a retail minimum and a retail maximum within a five-tier structure (see chart below). You will pay the co-insurance amount subject to the retail minimum and maximum cost. You do not have to meet your deductible first.

pos prescription tiers 2018

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