Health Plans For California Federal Employees
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Anthem Blue Cross Select HMO

 

Anthem Blue Cross Select HMO provides more of what you want – more choices, more convenience, and more control. That’s a lot of more, with Anthem as your dedicated, dependable partner on your healthcare journey.

 

 With Anthem Blue Cross Select HMO:

 

You have to stay in network.

 

 

You’ll have predictable out-of-pocket costs.

 

 

There’s no annual deductible.

 

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Pharmacy Benefits

 

Prescription Drug Copays For 2024

This table shows your monthly and yearly costs for prescription drugs in 2024. If you have any questions about your coverage, call the Member Services number on the back of your identification card.

. Opens in new window Find Your Prescription Drug
. Opens in new window Find Participating Pharmacies
. Opens in new window Price A Medication*
Level 1 Retail Pharmacies

Item

 30-Day Supply (Retail) Yearly Cost 30-Day Supply (Retail) 90-day Supply (Mail Order) Yearly Cost 90-Day Supply (Mail Order)
Tier 1

$10 copay

$120

$20 copay

$80
Tier 2

$50 copay

$600

$100 copay

$400
Tier 3

$80 copay

$960

$160 copay

$640
Tier 4

25% of our allowance ($250 maximum per prescription)

-

90-day supply is not available

90-day supply is not available
Level 2 Retail Pharmacies

Item

 30-Day Supply (Retail) Yearly Cost 30-Day Supply (Retail) 90-day Supply (Mail Order) Yearly Cost 90-Day Supply (Mail Order)
Tier 1

$20 copay

$240

N/A

N/A
Tier 2

$60 copay

$720

N/A

N/A
Tier 3

$90 copay

$1,080

N/A

N/A
Tier 4

25% of our allowance ($250 maximum per prescription)

-

N/A

N/A

* Please note that pricing information is based on filling prescriptions at a Level 1 pharmacy. Add $10 to your copay if you’re having your prescriptions filled at a Level 2 pharmacy.

Benefits Resources

. Opens in new window Summary Of Plan Coverage
. Opens in new window Anthem Blue Cross Select HMO Brochure
. Opens in new window Plan Archives

Helpful Links & Resources

. Opens in new window Claims Appeal Information
. Opens in new window General Plan Information
. Opens in new window Glossary