However, you will be subject to the deductible and may be billed above the network allowance. The best cost savings and convenience for you and your family are optimized when you use your Primary Care Physician. Prescriptions purchased at non-participating pharmacies would be the member's financial responsibility. Please refer to the provider directory for each of the POS plans for a list of participating pharmacies. Examples of Major Medical charges include doctor's office visits and prescription drugs.
Noted exceptions are for routine pap tests and mammograms.
Charges for routine mammograms are covered annually for individuals 50 and older. For individuals between ages 40 and 50, a routine mammogram is covered every other year. Reimbursement for prescription drug expenses under a PPO or Plan a may be accomplished in one of two ways. You may use any pharmacy and submit the receipts to the health plan administrator yourself for reimbursement. If you are enrolled in the Healthpass PPO or Plan A, you may use a participating pharmacy and receive an immediate up-front discount.