Prescription drugs

When you have a new prescription for a maintenance medication, you can fill the first two 30-day supplies at any H-E-B pharmacy. After that, you can save considerable money by ordering a 90-day supply through H-E-B.

This plan has no copays nor does it include any no-cost prescription. The cost of the prescriptions are combined with medical plan costs to create one annual deductible.

You pay 100% of your prescription drug expenses until you meet your medical annual deductible of $5,350 per individual *except for Preventive Care drugs which are covered at 100% – Deductible is waived. Once the medical deductible is met then your prescription drugs are covered at 100%. 

If you are enrolled in any of the medical plans, generic drugs for high blood pressure, high cholesterol, asthma, or diabetes (including injectable insulin) remain available at no cost to you. You will need to purchase 90-day supplies through H-E-B pharmacy.

In compliance with ACA rules, the plan also covers women's generic contraceptives at 100%, as well as those that have no generic available.

For specialty drugs, use H-E-B Rxtra Advantage specialty program. This program covers certain specialty medications and ensures that once you are enrolled and eligibility is confirmed, you have lesser financial responsibility for those medications.

Have questions? Call H-E-B RxTRA Advantage at 1-877-432-9355 to get started.

The prescription drug plan doesn't cover certain medicines without prior authorization for medical necessity. If you're currently using one of these drugs and don't get authorization from your doctor, you may have to pay the full cost of your medication. Another option is to choose a generic or brand formulary alternative. When you choose a drug from this list, you don't have to get prior authorization.

For more information about prescription drug coverage, call H-E-B RxTRA Advantage at 1-877-432-6315.