Deductible: Each year, your family is responsible for 100% your eligible prescription drug
and medical supply costs until your reach your deductible. Once you reach this amount, PharmaCare pays a percentage of
your eligible costs for the rest of the calendar year.
PharmaCare portion: PharmaCare pays a portion of your eligible costs after you reach your deductible
until the end of the year or until you reach your family maximum. You pay only the remaining cost. For example,
if the PharmaCare portion is 70%, you would pay the remaining 30% until you reach your family maximum.
Family Maximum: The family maximum protects you (and, if applicable, your family) from high expenses.
If your contributions towards eligible costs reach this amount, PharmaCare pays 100% of your eligible costs for the
rest of the year.
Eligible costs: If PharmaCare does not cover an item, you are responsible for the full cost.
If PharmaCare does cover an item, it sets a maximum amount it will cover for the prescription, medical supply
and dispensing fee. If a pharmacy or medical provider charges more than the maximum, you pay the difference in cost.
Only eligible costs count towards your annual deductible and family maximum.
You can also select one of the links below for more information on Fair PharmaCare assistance levels.
Regular Fair PharmaCare Assistance
Assistance for those born in or before 1939