Health New England Prescription Drug Benefit
Prescription Drugs
Your Prescription Drug benefit covers those items described in the HNE Formulary. Please Call Member Services or visit hne.com for a copy of the HNE Formulary.

Important Note:  Prescription drugs are subject to the Combined Medical/Pharmacy deductible for this plan. See the Summary of Benefits Chart for information about the deductible.

Copayment
At a Plan Pharmacy (up to a 30-day supply)  
Generic Drugs $10
Formulary Drugs $30
Non-formulary Drugs $60
Through Mail Order (up to a 90-day supply of maintenance medication)  
Generic Drugs $20
Formulary Drugs $60
Non-formulary Drugs $180

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