Pharmacy Benefits

Pharmacy Benefits Included in the Medical Plan

Prescription drugs are covered within the Medical Plan. Brand-name drugs have a combined annual deductible and out-of-pocket maximum with the medical benefits. The applicable cost share for covered Brand-Name drugs does apply after the deductible has been met. Generic Drugs have a co-pay, deductible is waived. The co-pay applies to the plan’s out-of-pocket maximum.

Select Brand Name and Specialty Drugs must be obtained through the Prescription Drug Plan’s Specialty Pharmacy, or CanaRx if available.

Generic: $10 Co-pay

Prescription Drug Card

Retail (30-day supply)

Mail Order (90-day supply)

Specialty Drugs (30-day supply)

Diabetes Management Program

Preferred Brand: 40% Co-pay

Non-Preferred Brand: 50% Co-pay

Generic: $20 Co-pay

Preferred Brand: 40% Co-pay

Non-Preferred Brand: 50% Co-pay

Generic: $10 Co-pay

Preferred Brand: 40% Co-pay

Non-Preferred Brand: 50% Co-pay

• Diabetes maintenance medication and supplies paid at 100% for members actively engaged in Disease Management

• Plan participants must maintain contact with Imagine360 Care Coach every 3 months

• Plan participants declining to participate will receive standard benefits under the Plan

To explore or register, please call Imagine360’s Medical Management Team at 800-716-2852 or email them at Myplan@imagine360.com.

Additional Source for Pharmacy

CanaRx is a voluntary prescription drug program that is available to eligible team members and their dependents.

This benefit provides a great opportunity to save $$ on your regular maintenance medications. All co-pays are waived for this program.

CanaRx is an International Mail Order Program.

A complete list of eligible medications and ordering instructions can be found at www.marinemaxmeds.com

PaydHealth is an additional alternative under the MarineMax Pharmacy Benefits. It offers innovative financial solutions for purchasing high-cost specialty drugs.

PaydHealth utilizes drug manufacturer programs to secure medications at a reduced price, or at no cost to the member. PaydHealth has a team that will work to secure funding for medication not covered under the insurance plan. There are manufacturer programs for many high-cost medications (typically, drugs over $1,000.) If your prescription drug is eligible for alternative funding and you qualify, you will be notified by PaydHealth