Prescription drugs

You can refill and renew prescriptions, view coverage and costs, and find nearby pharmacies on mycigna.com or the MyCigna mobile app.

What you’ll pay

You will pay less for generic drugs than for brand-name drugs. You’ll also save money when you fill 90-day prescriptions for maintenance medications through the Cigna 90 Now home delivery program or at an in-network retail pharmacy.

Generic preventive prescriptions are covered at 100%. For other drugs, you pay a copay or percentage of the cost, based on the drug tier (e.g., generic, preferred brand, or nonpreferred brand). Find a drug’s tier on the Cigna 2024 drug list [PDF].

See the 2024 plan comparison chart [PDF] for the copays and coinsurance by plan and drug tier. Note that, in the HSA plan, you must meet your deductible before the plan begins to pay its share of costs.

Step therapy

To help you and your doctor find the most cost-effective, clinically appropriate medication, Cigna may ask you to try “step therapy” before choosing other, more costly medication options.

• Step 1: generic medication (lowest cost)
• Step 2: preferred brand medication (medium cost)
• Step 3: nonpreferred brand medication (highest cost)

Medications covered by step therapy include those used to treat ADD/ADHD, allergies, depression, high blood pressure, osteoporosis, and sleep disorders. You and your doctor will be advised by Cigna if your prescription is subject to step therapy.

Other things to know

Dispense-as-written requirement: If your doctor writes a brand-name prescription when a generic equivalent is available, you’ll pay the regular copay or coinsurance, plus the difference in cost between the brand-name and generic drug. You can request an exception by having your doctor contact Cigna to explain why a generic equivalent is not acceptable.

Specialty pharmacy: For drugs on the Cigna specialty medications list [PDF], you’ll need to fill your prescriptions through Accredo, the Cigna specialty pharmacy. Patients with diabetes or a pulmonary condition can also fill 90-day prescriptions through Accredo.

Questions?

If you have questions about prescription drug coverage, call Cigna One Guide at 888-806-5042.

The Kaiser plan manages its own in-network prescription drug benefits.

You pay a copay, based on the drug tier (e.g., generic or brand name). Find a drug’s tier on the Kaiser California commercial formulary.

See 2024 plan comparison chart [PDF] for the copays and coinsurance by drug tier (e.g., generic, preferred brand, or nonpreferred brand).