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  3. Benefits FAQ
  4. Q&A: Pharmacy/Prescription Benefits

Q&A: Pharmacy/Prescription Benefits

  • A: Yes, for most prescriptions you can get “3 months for the price of 2”, meaning a 90-day supply for the price of two 30-day supplies (or two retail co-pays).  Certain drugs have restrictions that prevent them from being sent in larger quantities, or that prevent mail-order delivery altogether.  To get a detailed description of the cost savings for mail order vs. retail pharmacy, please view your specific Summary of Benefits and Coverage by clicking here.  You can confirm whether this discount is available for your particular prescription by calling your medical insurance provider. 

    OEBB Moda Health Pharmacy Customer Service at (866) 923-0411.

    OEBB Kaiser Permanente Pharmacy Customer Service at (800) 548-9809

  • A: MODA:  There are 2 provider choices for mail order pharmacy services.  You can choose between Ardon Health Specialty Pharmacy and Postal Prescription Services (PPS).

    • Ardon Customer Service: (855)425-4085.  Monday – Friday: 8:00 a.m. – 7:00 p.m. PT and Saturday: 8 a.m. – 12 p.m. PT
    • PPS Customer Service: (800)552–6694.  Monday – Friday: 6 a.m. – 6 p.m. PT and Saturday: 9 a.m. – 2 p.m. PT

     

    A:  KAISER:  To sign up for mail order delivery call (800) 548-9809 or go online to KP.org and sign into your My Account.

  • A: Moda regularly updates their prescription formulary. You’ll want to check the Moda website to get the latest list for their pharmacy page. It contains many helpful links, including current and soon-to-be-effective prescription formularies.

    A: Kaiser regularly updates their prescription formulary. You’ll want to check the Kaiser website to get the latest list for their pharmacy services page, which contains many helpful links.

  • A: No, you do not have to meet a deductible in order to receive prescription benefits.  The benefits of the prescription coverage are available the first day your medical coverage is in effect.

    MODA: Rx applies toward Out-of-Pocket Maximum

    KAISER:  $1100 – Rx max also applies to Medical Out-Of-Pocket Maximum

  • A: Yes.  The copay amounts are different within the different Medical insurance plans and networks.  Please review the Summary of Benefits and Coverage for the appropriate plan and network (either Moda or Kaiser) here.

  • A: No, the 4J plans have the prescription benefit tied in with the medical coverage — it is not available separately.