How does the separate Rx out-of-pocket maximum work?

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For the Advantage High and Value plans, members only pay the copayment amount for prescription drugs (or the cost of the drug, whichever is lower). Once the member’s copayments total a certain amount (see N. Plan Maximum for Prescription Drugs on Summary), the member has 100% coverage for eligible prescription drugs for the remainder of the plan year. (For the HSA, the deductible and out of pocket maximum is combined. Once the combined out of pocket maximum is met, member has 100% coverage for eligible medical and prescription drugs for the remainder of the year.)

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