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    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

    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). 

     

    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 Summary Plan Description. See Note below.

     

    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%

     Note: There is no Coordination of Benefits for pharmacy benefits.

    Additional Resources:

     

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