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Committed to Safety: As we resume services, we are taking all necessary precautions to keep you safe while we care for you. Limited visitation is now in place. Review all our visitor policies and precautions. Get more information on COVID-19.

MedImpact

Connect with MedImpact by calling our Cone Health dedicated customer service line at 844-401-2055

Prescription Drug Plan

The prescription drug program is the same for all three health care plans – Choice, Save and Focus. However, with Choice and Focus Plans, prescription drugs are not subject to the deductible and the plan will pay according to the schedule below in January. Copays remain the same for 2021.

Remember that with the Save Plan, the full cost of prescription drugs must be paid for by you until your deductible is met. Once your deductible is met, the prescription drug plan will pay as listed on the schedule below. The only exception is the list of Safe Harbor medications. The Safe Harbor list allows Save Plan members to receive those medications at the same cost as the Choice and Focus Plans before meeting the deductible.

Manufacturer copay savings cards or coupons used at the pharmacy will NOT be applied to your deductible or out-of-pocket maximum amounts. Only your TRUE out-of-pocket expense will apply to the deductible and out-of-pocket maximum.

Mail Order

Do you live outside of the Alamance, Guilford or Rockingham County areas in North Carolina or in Virginia or just having a hard time getting to the Cone Health Outpatient Pharmacies before they close? Cone Health operates a Mail Order service out of the Wesley Long Outpatient Pharmacy for employees who live in North Carolina and Virginia (the states where we are licensed to provide mail order). In previous years, there was a shipping charge per package mailed. There are NO shipping charges for Cone Health Mail Order services in 2021.

Complete a Mail Order Form

NEW - Diabetes Pharmacy Benefit & Rewards Program

Cone Health is dedicated to expanding the pharmacy benefit coverage of diabetes medications and supplies through a rewards program. You and your dependents actively engaged in Active Health Management (AHM) or Wellsmith are eligible to earn cash rewards through a quarterly payroll payout to offset your diabetes medication and supply costs. Learn More | FAQs | Estimated Copay Card Info

2021 Prescription Drug Benefit

Cone Health Outpatient Pharmacies
30/60/90 days
Other Retail
Only 30 Days
MedImpact Mail Order
90 days
Only NC and VA Cone Health Mail Order
30/60/90
Free generic list
$0
Only available at Cone Health Outpatient Pharmacy
Only available at Cone Health Outpatient Pharmacy
$0
Preferred Generic List
$5/$10/$15
$20
$60
$5/$10/$15
Non-Preferred Generics
20% with minimum of $15/$30/$45 No maximum limit
30% with minimum of $25 No maximum limit
30%
20% with minimum of $15/$30/$45 No maximum limit
Preferred Brand
20% with minimum of $30/$60/$90
30% with $50 minimum and $150 maximum
$250
20% with minimum of $30/$60/$90
Non-Preferred Brand
20% with minimum of $100/$200/$300 No maximum limit
50% with minimum of $150 and $350 maximum
$350
20% with minimum of $100/$200/$300 No maximum limit
Specialty - Generic
20% with $15 minimum and $250 maximum
Only available at Cone Health
Only available at Cone Health
30 days only 20% with $15 minimum and $250 maximum
Specialty - Brand Name
Variable Copay*
Only available at Cone Health
Only available at Cone Health
Variable Copay*
* Variable Copay - copay varies in cost based on participation in Specialty Clinic benefit and available manufacturer copay cards that can be applied at the pharmacy to offset out-of-pocket costs.

Please Note:

  • Maintenance drugs must be filled by the Cone Health Outpatient Pharmacies, either in person or by Cone Health mail order. Only one 30-day prescription will be available at retail stores
  • A prior authorization will be required for any branded medication that has a generic equivalent.

Visit a Cone Health Pharmacy

Enroll Now

Access the myBenefits Portal

For personal help by phone, please call the Benefits Call Center at (336) 832-8777 from 8:30 a.m. to 5 p.m. Monday through Friday.

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