Georgia Plan Benefits
Blue Open Access POS
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With Blue Open Access POS, you get more of what you want – more choices, more convenience and more control. That’s a lot of more. And with Anthem, you get a dedicated, dependable partner to join you on your journey.
Learn more about the Blue Open Access POS
Let’s break down details of the Blue Open Access POS plan.
- You can visit network or non-network providers
- Know before you go: Those non-network providers are going to cost a little more out-of-pocket for you
- When you see network providers, there’s no deductible . . . you’ll have lower out-of-pocket, too
Pharmacy Benefits
Prescription Drug Copays for 2022
With Blue Open Access POS you can choose between Level 1 or Level 2 pharmacies. Level 1 pharmacies have lower copayments than Level 2. Please contact customer service to get a list of Level 1 and Level 2 pharmacies.
Level 1 |
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|---|---|---|---|---|
| 30-Day Supply (Retail) | Yearly Cost 30-Day Supply (Retail) | 90-day Supply (Mail Order) | Yearly Cost 90-Day Supply (Mail Order) | |
| Tier 1 | $5 copay | $60.00 | $10 copay | $40.00 |
| Tier 2 | $70 copay | $840.00 | $175 copay | $700.00 |
| Tier 3 | $110 copay | $1,320.00 | $275 copay | $1,100.00 |
| Tier 4 | 35% of our allowance ($350 maximum per prescription) |
— | 90-day supply is not available | 90-day supply is not available |
Level 2 |
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|---|---|---|---|---|
| 30-Day Supply (Retail) | Yearly Cost 30-Day Supply (Retail) | 90-day Supply (Mail Order) | Yearly Cost 90-Day Supply (Mail Order) | |
| Tier 1 | $20 copay | $240.00 | N/A | N/A |
| Tier 2 | $80 copay | $960.00 | N/A | N/A |
| Tier 3 | $120 copay | $1,440.00 | N/A | N/A |
| Tier 4 | 35% of our allowance ($350 maximum per prescription) |
— | 90-day supply is not available | 90-day supply is not available |
On the next page, choose Essentials Tier-4
*Please note that pricing information is based on filling prescriptions at a Level 1 pharmacy. Add $10 to your copay if you’re having your prescriptions filled at a Level 2 pharmacy.
