The Traditional Formulary benefit has either a flat copayment/coinsurance, one copayment for generic or one copayment for brand, or assigns each prescription medication to one of two different tiers, each representing a set copayment amount. The copayment amount will depend on your prescription medication rider. Additional medications, other than those included in this formulary, may be covered under the Traditional benefit.
For information about specific prescription medication benefits, please contact the Pharmacy Customer Service Team at 1-800-988-4861.
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