Pharmacy Benefits 2021-2022

Arizona Board of Regents Student Health Insurance Plan Pharmacy Benefits

Use Aetna Participating Pharmacies & present insurance ID card

The UA Campus Health Pharmacy is a participating pharmacy under the plan

Aetna’s online provider directory: select “Find a Doctor or Hospital”

Aetna's Advance Control formulary information.

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 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.