| Medical Plan Choice | BCBS PPO Plan | BCBS Health Savings Plan | ||
|---|---|---|---|---|
| Prescriptions | Retail 30 day supply |
Mail Order 90 day supply |
Retail 30 day supply |
Mail Order 90 day supply |
| Tier 1 | $10 | $20 | 80%* | 80%* |
| Tier 2 | $30 | $60 | 80%* | 80%* |
| Tier 3 | $60 | $120 | 80%* | 80%* |
| Tier 4 | $90 | $180 | 80%* | 80%* |
* = After deductible