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Pensions and Benefits
STATE HEALTH BENEFITS PROGRAM (SHBP)
RETIREE PRESCRIPTION DRUG COPAYMENTS
(NJ DIRECT10 and NJ DIRECT15 PLANS)

STATE AND LOCAL GOVERNMENT RETIREE COPAYMENT AMOUNTS

Click for Local Education Retiree Copayments

Plan Year 2011 prescription drug copayments for Retired Group State Health Benefits Program (SHBP) members enrolled in NJ DIRECT10 or NJ DIRECT15.

Effective January 1, 2011, Medco Health Solutions, Inc.
will administer prescription drug benefits for the SHBP.

RETAIL PHARMACY COPAYMENT AMOUNTS
Up to a 90-day Supply

Supply Generic Preferred Brand All Other Brands
01-30 days
$10
$22
$44
31-60 days
$20
$44
$88
61-90 days
$30
$66
$132

MAIL ORDER COPAYMENT AMOUNTS
Up to a 90-day Supply

Supply Generic Preferred Brand All Other Brands
01-90 days $11 $33 $55

MAXIMUM OUT-OF-POCKET AMOUNT

Effective January 2011, there is an annual maximum out-of-pocket amount for prescription drug copayments of $1,351 per person. Once a person has paid $1,351 in copayments in a calendar year, that person is no longer required to pay any prescription drug copayments for the remainder of that calendar year.

Prescription drug copayments are not eligible for further reimbursement and do not apply to medical plan deductibles or coinsurance.

If you have any questions regarding this information, contact the Office of Client Services at
(609) 292-7524 or send an e-mail using the "contact us" link below.

 
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