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Pharmacy Benefits

Your Prescription Copays
at a Glance.

Here's what you'll pay at the pharmacy. Save this page for quick reference — and if the price doesn't match, don't pay until you call us.

Generic
$0
Most common medications — always ask the pharmacist for generic
Preferred Brand
$25
Brand-name drugs on the preferred formulary list
Non-Preferred Brand
$55
Brand-name drugs not on the preferred list
Specialty
$200
High-cost specialty medications — typically require prior auth
These are your standard copays for a 30-day retail supply. Your specific plan may vary — check your member portal for your exact benefit summary. If the pharmacy quotes a price that doesn't match, call (877) 426-2162 before paying.
ⓘ
On a High Deductible Health Plan (HDHP)? The copays above may not apply until you've met your annual deductible. Until then, you'll pay the plan's negotiated rate for most prescriptions — which is still lower than retail. Certain preventive medications may be covered at $0 before your deductible. Check your member portal or call (877) 426-2162 to confirm what applies to your plan.
Getting Started
How to Fill a Prescription

Filling a prescription with Level Health works the same as any other health plan. Bring your ID card to any in-network pharmacy, and the pharmacist will process your prescription through your plan automatically.

If this is your first visit to a new pharmacy, the pharmacist may need to enter your plan information manually. Everything they need is on the back of your ID card: the Rx BIN, Rx PCN, Rx Group, and your Member ID.

01
Get your prescriptionFrom your doctor, urgent care, or through your $0 primary care provider
02
Go to any in-network pharmacyMost major chains and local pharmacies are in-network
03
Show your Level Health ID cardThe pharmacy will process your Rx through the plan — Rx info is on the back
04
Pay your copay and go$0 for generics, $25-$200 for brands depending on tier
⚠
Price doesn't look right?Don't pay full price — call (877) 426-2162 before leaving the pharmacy
$0
Generic Copay
90%+
of prescriptions
have a generic option
Same
active ingredient
as the brand name
Save Money
Generic Medications Are $0. Always Ask.

Most prescriptions have a generic equivalent that contains the same active ingredient, in the same dose, with the same clinical effect — at a fraction of the cost. On your Level Health plan, generics are $0.

If your doctor writes a prescription for a brand-name medication, ask them: "Is there a generic available?" In most cases, the answer is yes. Switching to generic saves you money and doesn't change your treatment.

If your doctor determines that the brand-name version is medically necessary, your plan still covers it — you'll just pay the brand copay tier instead of $0.

Quick Tip

You can also ask the pharmacist at the counter. They can check if a generic is available and switch it right there — no need to go back to your doctor.

Ongoing Medications
Taking the Same Medication Every Month?

If you take a medication regularly — for blood pressure, cholesterol, diabetes, thyroid, or any ongoing condition — you may be able to switch to a 90-day supply through mail order.

Mail order delivers your medications directly to your door and typically costs less per dose than picking up a 30-day supply at a retail pharmacy. Ask your doctor to write a 90-day prescription, or call member support for help setting it up.

🏪
Retail Pharmacy 30-day supply, pick up in person each month
Standard
📦
Mail Order (90-Day Supply) Delivered to your door, fewer refills, often lower cost per dose
Recommended
Important
The Price Doesn't Look Right?
If the pharmacy quotes you a price that's higher than your copay, something may be off. Do not pay full price. Here's what to do — and the most common reasons it happens.
📞

Call (877) 426-2162 before you pay.

Our team can check your coverage in real time, contact the pharmacy directly, and resolve the issue while you're still at the counter. Do not pay the full retail price. There is almost always a fix.

Common Reasons the Price Is Wrong
💳
Pharmacy doesn't have your plan on fileEspecially on your first visit. Give them your ID card — the Rx BIN, PCN, and Group are on the back.
💊
Brand was dispensed instead of genericAsk the pharmacist if a generic is available. Generics are $0 — brands are $25-$200 depending on tier.
📋
Medication requires prior authorizationSome medications need clinical approval before they're covered. Your doctor can submit this — call us for help.
🔄
Claim processed through wrong planIf you recently switched to Level Health, the pharmacy may still have your old carrier on file. Show them your current card.
Pharmacy Tools
Quick Links
🏥

Find a Pharmacy

Search for in-network pharmacies near you by ZIP code or city.

→
📚

Check if Your Medication Is Covered

Search the formulary to see if your medication is covered and which copay tier it falls under.

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💻

Log In to Member Portal

View your pharmacy claims, check coverage details, and access your digital ID card.

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Need Help?
Questions about your pharmacy benefits?
Our member support team can help with coverage questions, pharmacy issues, prior authorizations, and anything else related to your prescriptions.
Call (877) 426-2162 Log In to Member Portal