Home > Benefits & Retirement > Prescription Drugs

Prescription Drugs

When you enroll in a BMO medical plan, you automatically receive prescription drug coverage.

Prescription drug coverage is available through Express Scripts if your medical plan is administered by BCBSIL and through Kaiser Pharmacy if Kaiser administers your medical plan. Here’s a high-level overview of prescription drug benefits.

BCBSIL: Express Scripts

In-Network Features	HDHP	PPO
Annual Deductible	Combined with medical	Individual: $250 Family: $500 (for prescription drugs only)
Annual Out-of-Pocket Maximum	Combined with medical
Good to Know	BMO provides digital ID cards exclusively through Express Scripts; physical cards are not provided. You can access your digital ID card anytime on the Express Scripts website or the mobile app. You must fill maintenance medications through a Smart90 retailer (Walgreens or CVS), or ESI home delivery You can get two retail 30-day grace fills for maintenance medications. Subject to the deductible (some exclusions apply) Lifetime limit for Infertility medications: $40,000
	What You Pay
Generic	Retail: $10 copay Mail order: $25 copay
Formulary (preferred brand)	30% coinsurance Retail: $25 minimum; $100 maximum Mail order: $62.50 minimum; $250 maximum
Non-Formulary (non preferred brand)	40% coinsurance Retail: $50 minimum; no maximum Mail order: $125 minimum; no maximum
Specialty Drugs	Based on category (generic, formulary, non-formulary). Must be filled through Express Script’s specialty mail order pharmacy

Kaiser Pharmacy

In-Network Features	HDHP	DHMO
Annual Deductible	Combined with medical	Individual: $250 Family: $500 (for prescription drugs only)
Annual Out-of-Pocket Maximum	Combined with medical
	What You Pay
Generic	Retail: $10 copay Mail order: $20 copay
Formulary (preferred brand)	30% coinsurance Retail: $30 minimum; $100 maximum Mail order: $60 minimum; $200 maximum
Non-Formulary (non preferred brand)	40% coinsurance Retail: $140 minimum; $350 maximum Mail order: $280 minimum; $700 maximum
Specialty Drugs	30% coinsurance Retail: $75 minimum; $250 maximum