Pharmacy Benefits 2017-2018
Arizona Board of Regents Student Health Insurance Plan Pharmacy Benefits
Use Aetna Participating Pharmacies & present insurance ID card
UA Campus Health Service Pharmacy is a participating Pharmacy under the plan
Aetna’s on-line provider directory: www.aetnastudenthealth.com select “Find a Doctor or Hospital”
Preferred Care Policy Year Out-of-Pocket Maximum: Combined Medical & Pharmacy $1,500 (includes co-payments, deductible and co-insurance).
Policy Year Pharmacy Deductible: $125 (is waived at the UA Campus Health Service Pharmacy)
Prescription Co-pay Schedule
Generics: $ 15 co-pay
Brands Preferred: $40 co-pay
Brands Non-Preferred: $80 co-pay
Specialty Medication: $80 co-pay
Generic contraceptive is covered at 100%
Important Note: Brand-name contraceptive prescription drugs or devices from a preferred provider will be covered at 100% of the negotiated charge, including waiver of per policy year pharmacy deductible if a generic contraceptive prescription drug or device is not available in the same therapeutic drug class or the prescriber specifies dispense as written.