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2019 Coverage

Farm Bureau Essential Rx 2019 Coverage

Enrollment
844-368-8738

All Other Inquiries
866-643-6924

7 Days a Week
8am - 8pm

TTY
711

About the Plan:

Our lower-premium plan covers a broad range of generic and brand name drugs. The plan’s five tiers of coverage give you cost sharing among generics and brand name drugs, as well as specialty drugs.

The plan has an annual deductible of $415.

For any preferred generic drug, you pay no more than $4 per fill after the deductible is met. For any Preferred Brand drug, no more than $40 per fill after deductible is met.

Highlights:

  • Monthly premium: $59.10
  • Annual deductible: $415
  • Tier 1- Preferred Generics: $4 copay per fill
  • Tier 2 - Generics: $9 copay per fill
  • Tier 3 - Preferred Brands: $40 copay per fill
  • Tier 4 - Non Preferred Generic/ Non Preferred Brand: 45% coinsurance per fill
  • Tier 5 - Specialty Generics or Brands 25% coinsurance per fill
     Note: Per fill is equal to a 30 day supply
Prescription Drugs Benefits
Prescription Drug Benefits
Drug Copay & Discounts
Prescription Drugs Your Costs
Annual Prescription Deductible $415
Initial Coverage Stage   Standard Network Pharmacy Cost Sharing (30 days) Preferred Mail Order Pharmacy (90 days)
Tier 1: Preferred Generic Drugs   $4 copay $12 copay
Tier 2: Generic Drugs   $9 copay $27 copay
Tier 3: Preferred Brand Drugs   $40 copay $120 copay
Tier 4: Non-Preferred Generic/Brand Drugs   45% of the cost 45% of the cost
Tier 5: Special Tier Drugs   25% of the cost 25% of the cost
Coverage Gap Stage

Once a member's total drug costs have reached $3,820, they move to the Coverage Gap Stage.

Generic Drugs

- Member pays 37% of the price and the plan pays the remaining 63%. The amount paid by the plan (63%) does not count toward the members out-of-pocket costs. Only the amount paid by the member moves them through the coverage gap.

Brand Drugs

- Member pays 25% of the plan's negotiated price and a portion of the dispensing fee. The manufacturer provides a 70% discount excluding any dispensing fee. The amount paid by the member and the manufacturer discounted amount count towards the member's out-of-pocket cost. The amount paid by the plan (5%) does not count towards the member's out-of-pocket cost.

Once the member's out-of-pocket costs reach $5,100, they move to the Catastrophic Coverage Stage.
 

Catastrophic Coverage Stage

A member enters the Catastrophic Coverage Stage after $5,100 out-of-pocket costs are reached (excluding premiums). Through the end of the year, member pays the greater of: Generic drugs - $3.40 copay or a 5% coinsurance; Brand name drugs - $8.50 copay or a 5% co-insurance. On January 1 each year, the five drug payment stages start over.

Footnotes

  • Members may use any pharmacy not in the network but may not receive negotiated retail pharmacy pricing. Copays apply after deductible.

  • You are not required to use Farm Bureau Essential Rx mail order to obtain a 90-day supply of your maintenance medication. New prescriptions for Farm Bureau Essential Rx mail order should arrive within ten business days from the date the completed order is received and refill orders should arrive in about seven business days. Contact Farm Bureau Essential Rx at 1-866-643-6924 (TTY 711), 8am to 8pm, 7days a week.

  • Copays and coinsurance apply to all tiers during the initial coverage phase and do not apply during the coverage gap. Different copays or coinsurance apply during the catastrophic stage.

     

Ready to Enroll?

Farm Bureau Health Plans is proud to offer two Medicare Part D prescription drug plans at an affordable cost.

Get started by calling 844-368-8738 (TTY 711)