Prescription Drug Summary: Greenbrier Plan

Sav-Rx welcome letter for Greenbrier employees.

Present your Sav-Rx Prescription Drug Card at a participating pharmacy to access your benefits.

Program Generic Drugs Preferred Brand Name Drugs Non-Preferred Brand Name Drugs
Retail Program

Up to a 34-day supply or 100 units, whichever is greater

You pay $10 You pay $15 You pay $50
Mail Order Program

Up to a 90-day supply

You pay a $15 You pay $35 You pay $80
Voluntary Self-Injectable Specialty Drug Program You pay $10 You pay $15 You pay $50
In-Network Out-of-Pocket Maximum Employee Only $1,800;
Employee + One $3,600;
Family $5,400
Sav-Rx Network Usage Requirement Benefits are not payable for prescriptions filled at pharmacies that are not in the Sav-Rx network. Check to make sure that your pharmacy is part of the Sav-Rx network before filling your prescription. Note: Not all chains/pharmacies are in the Sav-Rx network, including Wal Mart, Sam’s Club, and certain Rite-Aid locations.
Generic Medication If your doctor indicates a generic medication is acceptable, but you choose to have your prescription filled with a preferred or non-preferred brand name drug, you must pay the difference in cost between the preferred or non-preferred brand name and the generic medication, plus the preferred or non-preferred brand name copayment amount.