Human Resources: Benefits & Wellness / Pharmacy Benefits

Pharmacy Benefits

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Navitus Customer Care (available 24/7)

Toll-free at 1-855-673-6504

TTY (toll-free) 711

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

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:

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Human Resources: Benefits & Wellness