Prescription Drug Cost Lookup

1. Choose the link for FEHB coverage for your option (for example, High Option) above. You will be directed to PilotRx.
2. Type the first few letters or entire name of a drug, then choose the dose and form (capsule, tablet, liquid, etc.)
3. You will see the cost-sharing you pay in the “Your Cost” column. Note the tool will show the most common quantity and day supply for that drug. If you change the location or quantity, the results will be added to your list so you can compare all your options.
4. If you see “Not Covered”, “N/A” for cost-sharing or want to find a lower cost drug, press “View Most Commonly Dispensed Similar Drugs”. You may find a generic equivalent that will save you money.

1. Choose the link for “FEHB coverage with Senior Advantage for Federal Members” above. You will be directed to OptumRx.
2. Scroll down to choose the “Drug pricing tool” link. You will be asked to:
   • Select a plan (for example, Standard Option Senior Advantage)
   • Enter a pharmacy location
   • Type a drug name (you may type the first few letters)
3. You will see the cost-sharing you pay in the “You pay” column. Note the tool will show the most common quantity and day supply for that drug. To find a lower cost drug, click on the “Lower cost options” tab.
4. If you choose a drug and it is not covered, you will see a “Coverage alert”.

• You can look up cost-sharing for a drug and learn how to save money by using a Kaiser Permanente medical office pharmacy or by getting refills through our mail order pharmacy
• You can find a plan pharmacy

• A formulary is a list of drugs determined to be safe and effective for our members by our Pharmacy and Therapeutics Committee. Preferred drugs are included in our formulary. Non-preferred drugs are not included in our formulary.
• Generic drugs are produced and sold under their generic names after the patent of the brand-name drug expires. Although the price is usually lower, the quality of generic drugs is the same as brand-name drugs. Generic drugs are also just as effective as brand-name drugs. The Food and Drug Administration (FDA) requires that a generic drug contain the same active drug ingredient in the same amount as the brand-name drug.
• Brand-name drugs are produced and sold under the original manufacturer’s brand name.
• Specialty drugs are high-cost drugs that are on our specialty drug list.
• A mail order pharmacy may provide a larger supply of drugs for lower cost-sharing. You may save money by using our mail order pharmacy.

Specific coverage information, including limitations and exclusions, is described in your FEHB brochure. See Section 5(f) Prescription drug benefits. You may also call a Federal Employee Health Benefits Specialist at 1-877-904-0016.