HSA Plan Prescription Drugs

Prescription drug coverage is part of your HSA medical plan and is administered through CVS Caremark.

About HSA Plan Prescription Drug Coverage

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 (see below).

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 following table shows what your responsibility is once your deductible is satisfied. For example, if the table shows coinsurance 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 Costs
TierCo-insurance30-day retail maximum
Zero0%$0
110%$25
220%$75
330%$120
440%$150
90-day supply is 2½ times the retail amount

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

Maintenance Drugs

If you take any maintenance prescription medications to treat certain ongoing medical conditions, you will need to fill your 90-day prescriptions in one of three ways:

  1. Through CVS Caremark’s mail order service
  2. At a CVS retail pharmacy location
  3. At an Emory pharmacy

If you attempt to fill a maintenance drug at a pharmacy other than CVS or Emory, you will be charged the full retail cost.

View list of Maintenance Drugs

Tier Zero Drugs

Prescription medications used to prevent and treat chronic health conditions such as congestive heart failure, diabetes, high blood pressure, high cholesterol, tobacco addiction and more, are covered at 100% which means you pay $0 for these drugs.

View list of Tier Zero Drugs

Tip: Save Money on Your Prescriptions

One way to save on your prescription costs is to buy generic drugs. Always ask your doctor and/or pharmacist if a generic version is available.