HEALTH

Prescription drugs

If you enroll in medical coverage through Illumina, you automatically get prescription drug coverage. Your coverage depends on the medical plan you choose.

The basics

How it works

If you enroll in the Traditional PPO or the Health Savings PPO, you receive prescription drug coverage through CVS/Caremark.

If you choose an HMO plan, you receive prescription drug coverage through your medical plan.

What's covered

Covered medications are divided into tiers: Generic, Preferred Brand, Non-Preferred Brand and Specialty.

In general, generics are the lowest-cost and prices increase with each tier.

See your plan’s formulary for a list of covered medications.

Your cost

Prescriptions are priced according to their tier, as shown in the chart below.

For medication taken regularly, Traditional PPO and Health Savings PPO members can get a 90-day supply at a CVS retail pharmacy, or via mail order. See below for HMO plan options.

How your plan covers medications

How you pay for your prescriptions depends on your medical plan:

  • Traditional PPO, Kaiser HMO, and Quartz: You’ll pay a copay for most medications
  • Health Savings PPO: You must meet your annual deductible before the plan begins to pay, except for certain preventive medications 

Be sure to review your plan details so you know what to expect. You can use Health Savings Account or Flexible Spending Account funds to pay for prescriptions and certain over-the-counter drugs and supplies.

Preventive medications

All plans cover certain preventive medications at no cost to you, including medications for contraception, quitting tobacco, HIV prevention and some vaccinations.

The Health Savings PPO requires you to meet the annual deductible before your prescriptions are covered, except for the medications that are on the plan’s Preventive Drug List. The drugs on this list are available for a copay before the deductible.

Specialty drugs

If you are enrolled in the Traditional PPO or Health Savings PPO, the PrudentRx program allows both you and Illumina to take advantage of the savings from pharmaceutical company copay assistance cards and coupons. If you are prescribed or already take a specialty drug, the CVS Specialty Pharmacy can provide instructions on how to sign up. You may also choose to contact PrudentRx directly at 1-800-578-4403. Once signed up, your cost for these high-cost medications will be $0. If you do not sign up for PrudentRx, your cost will increase to 30% of the actual cost of the drug with no maximum.

What you pay for care

Coverage
Administrator
Quantity
Generic
Preferred brand
Non-preferred brand
Specialty

Traditional PPO

In-network and out-of-network

In-network only

CVS/Caremark

CVS/Caremark

Up to 30-day supply

Up to 90-day supply

$10

$20

$30

$60

$50

$100

$0 with PrudentRx or 30%
(Out-of-network: Not covered)

$0 with PrudentRx or 30%

Health Savings PPO

In-network and out-of-network

In-network only

CVS/Caremark

CVS/Caremark

Up to 30-day supply*

Up to 90-day supply*

$5 after deductible

$10 after deductible

$20 after deductible

$40 after deductible

$40 after deductible

$80 after deductible

$0 with PrudentRx or 30%
(Out-of-network: Not covered)

$0 with PrudentRx or 30%

Kaiser HMO

(California)

In-network only

In-network only

Kaiser

Kaiser

Up to 100-day supply

Up to 100-day supply

$10

$10

$30

$30

$30

$30

$30

$30

Quartz HMO

(Wisconsin)

In-network only

In-network only

Quartz

Quartz

Up to 30-day supply

Up to 90-day supply

$10

Copay based on quantity

$35

Copay based on quantity

$60

Copay based on quantity

$200

Copay based on quantity

*Prescriptions on the plan's list of Preventive Drugs are covered without having to meet the deductible.

See what you pay for medical coverage

Get in touch

CVS Caremark

Policy: RX25FN

Kaiser Permanente

Policies: No. CA – 36444 | So. CA – 226465

Quartz

Policy: HMO 9011682

More to explore

Medical
Flexible Spending Accounts (FSA)
Health Savings Account (HSA)
Plan Documents
Dental
Reproductive health and fertility

This website provides an overview of the benefit plans and programs available to eligible Illumina, Inc. employees. It is intended for informational purposes only and does not create any contractual rights or entitlements. If there is any discrepancy between the information on this site and the official plan documents or insurance contracts, the plan documents or contracts will govern. Illumina, Inc. reserves the right to add, delete or change any of the benefit programs at any time, for any reason, subject to applicable law.