•  

    Pharmacy Benefits 

     

    Navitus logo

     

    Navitus Customer Care (available 24/7)

    Toll-free at 1-855-673-6504

    TTY (toll-free) 711

    Website: www.navitus.com

     

    Mail Order Program - Birdi (effective 7/1/21*)

    Sign up online at www.birdirx.com/or by calling Birdi at 1-855-247-3479. 

    Please allow 10 to 14 calendar days from the day you submit your order to receive your medicine(s). 

    *See iBriefing #12791

     

    Specialty Pharmacy Program - Lumicera Health Services

    The Navitus SpecialtyRx program serves members who take medicine(s) for certain chronic conditions. 

    To order a new prescription simply call Lumicera at 1-855-847-3553.

    Click HERE for more information on the Specialty Pharmacy Program.

     

    Overview of Pharmacy Benefits

    For additional information, click HERE to see the 2020-21 Summary Plan Description. 

    There is no Coordination of Benefits for Pharmacy Benefits.

    BASIC PATHWAY

     DEDUCTIBLE

    Per Covered
    Person 

    OUT OF POCKET MAXIMUM 

    GENERIC

    PREFERRED

    NON-PREFERRED

    INDIVIDUAL

    Per Covered Person 

    FAMILY

     

    $400

    $2,150

    $4,300

    40%

    40%

    60%

     

    CUSTOM PATHWAY

    DEDUCTIBLE

    Per Covered
    Person 

    OUT OF POCKET MAXIMUM

    GENERIC

    PREFERRED

    NON-PREFERRED

    INDIVIDUAL

    Per Covered Person 

    FAMILY

     

    $250

    $2,150

    $4,300

    30%

    30%

    50%

     

    ENHANCED PATHWAY

    DEDUCTIBLE

    Per Covered
    Person 

    OUT OF POCKET MAXIMUM

    GENERIC

    PREFERRED

    NON-PREFERRED

    INDIVIDUAL

    Per Covered Person 

    FAMILY

     

    $100

    $2,100

    $4,200

    20%

    20%

    40%

     

    Additional Resources:

     

    Return to Main Benefits & Wellness Page