Prescription Drugs
Available for Full-Time and Part-Time Krispy Kremers
A spoonful of sugar can help the medicine go down. And so can the savings you experience with a Krispy Kreme prescription drug plan! Your coverage depends on the medical plan you elect.
Cigna Plans
If you’re enrolled in one of the Cigna plans (the Kreme Filled Open Access Plus (OAP) Plan, the Sprinkles HSA Plan or the Original HSA Plan), you receive prescription drug coverage through RxBenefits and Express Scripts. Most retail pharmacy chains participate in the network, but double-check before you go, to make sure you get the best rate. Out-of-network pharmacies require you to pay the whole cost of the drug at the time of purchase and submit a claim for partial reimbursement.
If you’re prescribed maintenance medications to treat a chronic condition, like high blood pressure, you can receive your prescriptions through either the Mail-Order Pharmacy Program or a retail pharmacy.
Questions? Check out the RxBenefits FAQ, or contact the RxBenefits Member Services team Monday–Friday, 7 a.m.–8 p.m. CT, by calling 800-334-8134 or emailing RxBenefits.
Kreme Filled OAP Plan
With the Kreme Filled OAP Plan, you pay a flat copay for your prescriptions. There’s no deductible to meet. If you hit your annual out-of-pocket maximum, the Plan will pay for your prescriptions at 100% through the end of the year.
| Retail Pharmacy (1–30-Day Supply) |
Retail Pharmacy for Maintenance Medications (31–90-Day Supply) |
Mail-Order Pharmacy for Maintenance Medications (31–90-Day Supply) |
|
|---|---|---|---|
| Generic Drugs | $15 | $38 | $38 |
| Preferred Brand-Name Drugs | $35 | $88 | $88 |
| Non-Preferred Brand-Name Drugs | $70 | $175 | $175 |
| Out-of-Pocket Maximum You’ll Pay Each Year* | $5,000 per individual / $10,000 per family | $5,000 per individual / $10,000 per family | $5,000 per individual / $10,000 per family |
*The calendar year out-of-pocket maximum applies to pharmacy and medical claims. Each individual family member must meet the individual out-of-pocket maximum, unless the family out-of-pocket maximum has been met by any two or more covered family members. Once met, your covered prescriptions are paid at 100%.
Original HSA Plan
If you’re enrolled in the Original HSA Plan, you pay nothing for your prescriptions after you meet your annual deductible. The deductible includes your medical costs.
| Retail Pharmacy (1–30-Day Supply) |
Retail Pharmacy for Maintenance Medications (31–90-Day Supply) |
Mail-Order Pharmacy for Maintenance Medications (31–90-Day Supply) |
|
|---|---|---|---|
| Annual Deductible (Includes Medical) | $6,500 per individual / $13,000 per family | $6,500 per individual / $13,000 per family | $6,500 per individual / $13,000 per family |
| Generic Drugs | $0 after deductible | $0 after deductible | $0 after deductible |
| Preferred Brand-Name Drugs | $0 after deductible | $0 after deductible | $0 after deductible |
| Non-Preferred Brand-Name Drugs | $0 after deductible | $0 after deductible | $0 after deductible |
| Out-of-Pocket Maximum You’ll Pay Each Year* | $6,500 per individual / $13,000 per family | $6,500 per individual / $13,000 per family | $6,500 per individual / $13,000 per family |
*The calendar year out-of-pocket maximum applies to pharmacy and medical claims. Each individual family member must meet the individual out-of-pocket maximum, unless the family out-of-pocket maximum has been met by any two or more covered family members. Once met, your covered prescriptions are paid at 100%.
Sprinkles HSA Plan
If you’re enrolled in the Sprinkles HSA Plan, you pay 25% of the cost of your prescriptions after you meet your annual deductible.
| Retail Pharmacy (1–30-Day Supply) |
Retail Pharmacy for Maintenance Medications (31–90-Day Supply) |
Mail-Order Pharmacy for Maintenance Medications (31–90-Day Supply) |
|
|---|---|---|---|
| Annual Deductible (Includes Medical) | $2,500 per individual / $5,000 per family | $2,500 per individual / $5,000 per family | $2,500 per individual / $5,000 per family |
| Generic Drugs | 25% after deductible | 25% after deductible | 25% after deductible |
| Preferred Brand-Name Drugs | 25% after deductible | 25% after deductible | 25% after deductible |
| Non-Preferred Brand-Name Drugs | 25% after deductible | 25% after deductible | 25% after deductible |
| Out-of-Pocket Maximum You’ll Pay Each Year* | $6,000 per individual / $12,000 per family | $6,000 per individual / $12,000 per family | $6,000 per individual / $12,000 per family |
*The calendar year out-of-pocket maximum applies to pharmacy and medical claims. Each individual family member must meet the individual out-of-pocket maximum, unless the family out-of-pocket maximum has been met by any two or more covered family members. Once met, your covered prescriptions are paid at 100%.
Mini Plan
If you’re enrolled in the Mini Plan, you have prescription drug coverage. For generic and brand prescriptions, the plan pays you $30 per day up to the annual maximum of $300 for drugs dispensed by a pharmacist. Prescription drug coverage is not provided for drugs administered during a physician office visit or hospital stay. If you choose a participating pharmacy and present your ID card, you will receive a discount off the retail price of the prescription at the time of purchase. You will then need to file your claim for reimbursement with BCS Insurance Company. Refer to your Summary Plan Description for details and claim forms.
Make your experience even sweeter—and save money—by downloading the Express Scripts mobile app.
Virtual Visits and Prescriptions
If you use ReviveHealth to supplement your medical care, you may be eligible to receive certain prescription medications at no cost to you. If your ReviveHealth doctor prescribes a covered medication, it will be processed and delivered to your home within three to five days. You’re eligible for one shipment per month with no copay.
Get a healthy sprinkling of savings by selecting generics whenever you can. Generic medications contain the same active ingredients as their brand-name counterparts but generally cost much less.
