Health New England

Compare Our Plans

Pharmacy Riders

(Listed as Generic/Formulary/Non-Formulary Drugs)

NOTE: If you already have a rate proposal, the rate is based on the Pharmacy
Rider you chose when the rate was generated.
Please check your rate proposal for the correct Pharmacy Rider.

HMO
Plan Pharmacy $10/$20/$35 Mail Order $20/$40/$105
Plan Pharmacy $10/$25/$45 Mail Order $20/$50/$135
Plan Pharmacy $10/$30/$60 Mail Order $20/$60/$180
Plan Pharmacy $10/$50/$100 Mail Order $20/$100/$300
Plan Pharmacy $15/$50/$100 Mail Order $30/$100/$300
HDHP HMO ONLY Prescription drugs are subject to the combined Medical/Pharmacy deductible for HNE Wise^Plus and HNE Wise^Max.
Deductible then: $10/$25/$45 Mail Order $20/$50/$135	Deductible then: $10/$30/$60 Mail Order $20/$60/$180

PPO

Plan Pharmacy

$10/$20/$35

Mail Order $20/$40/$105

Out of Plan retail only Copay + 20%

Plan Pharmacy

$10/$25/$45

Mail Order $20/$50/$135

Out of Plan retail only Copay + 20%

Plan Pharmacy

$10/$30/$60

Mail Order $20/$60/$180

Out of Plan retail only Copay + 20%

Plan Pharmacy

$10/$50/$100

Mail Order $20/$100/$300

Out of Plan retail only Copay + 20%

Plan Pharmacy

$15/$50/$100

Mail Order $30/$100/$300

Out of Plan retail only Copay + 20%

Copayments for prescriptions filled at a Plan Pharmacy reflect up to a 30-day supply. Copayments for prescriptions filled through mail order reflect up to a 90-day supply of maintenance medication. Please Call Member Services or visit hne.com for a copy of the HNE Formulary.