American Maritime Officers Medical Plan- Prescription Drug Benefit
Active & Pensioner Non Medicare Coverage:
Below is a summary of prescription drug benefits for American Maritime Officers Medical Plan. Should you have additional questions about the prescription drug benefit, please start by visiting the Smith Rx website @ www.mysmithrx.com or call their Customer Service department toll free at 1-844-454-5201. Smith Rx representatives are available 24/7 to assist with your prescription questions.
See the AMO Medical Summary Plan Description for a complete listing of RX Benefits and Exclusions and Limitations.
Deductible:
You have an annual deductible of $100.00 for an Individual or $200.00 per family that must be paid by you before your co-payments go into effect.
Your Co-payments:
|
RETAIL *
30 DAY SUPPLY |
RETAIL *
90 DAY SUPPLY-MAINTENANCE DRUGS |
| Generic Prescription Drugs |
$10.00 or 20% whichever is greater |
$10.00 or 20% whichever is greater |
| Brand Prescription Drugs |
$10.00 or 20% whichever is greater |
$10.00 or 20% whichever is greater |
| Brand Prescription Drugs with a generic available |
$10.00 or 20% whichever is greater plus the difference between the brand and the generic |
$10.00 or 20% whichever is greater plus the difference between the brand and the generic |