Prescription benefits

Prescription benefits — Get the prescription coverage and care you need

The following chart compares some commonly used prescription benefits between the existing coverage available under the NALC Health Benefit Plan High Option (for annuitants also enrolled in Medicare Parts A and B) and the NALC High Option Plan — Aetna Medicare Advantage.

See the 2026 Summary of Benefits (PDF) for additional plan details.

Please note: Manufacturer coupons and copay assist cards cannot be used with the NALC High Option Plan — Aetna Medicare Advantage plan.

Helpful links:

2026 Prescription drug lists

2026 - Comprehensive Plus Drug List (Formulary) (PDF)
2026 - Prior Authorization Information (PDF)
2026 - Step Therapy Information (PDF)
2026 - Summary of Changes (PDF)
2026 - Non-Part D Supplemental Benefit (PDF)
2025 - Essential Health Supplemental Benefit (PDF)
2025 - Drug List Changes (PDF)

Prescription coverage

Comparison table of Prescription coverage details.
Prescription coverage Existing
NALC Health Benefit Plan High Option plus separate enrollment in Medicare (assumes in-network providers are used)* 		New
NALC High Option Plan — Aetna Medicare Advantage
Retail pharmacy (30-day supply of a covered drug) Generic: 10%
Preferred brand: 20%
Non-preferred brand: 40%
Specialty: $200
 Generic: 10% coinsurance
Preferred brand: 20% coinsurance
Non-preferred brand: 40% coinsurance
Specialty: 25% coinsurance, up to $200
Mail order pharmacy or retail (90-day supply of a covered drug) Generic: 10% coinsurance, up to $250
Preferred brand: 20% coinsurance, up to $350
Non-preferred brand: 40% coinsurance, up to $500
Specialty: $500 copay 		Generic: 10% coinsurance, up to $250
Preferred brand: 20% coinsurance, up to $350
Non-preferred brand: 40% coinsurance, up to $500
Specialty: 25% coinsurance, up to $500

* The chart above assumes that the items and services are covered by Medicare unless specifically noted otherwise. The middle column in this chart assumes Medicare Parts A and B are primary and covered services are provided by doctors and facilities that participate with Medicare. The last column assumes that you have Medicare Parts A and B and have opted into the NALC High Option Plan — Aetna Medicare Advantage.

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Aetna Medicare is a PPO plan with a Medicare contract. Enrollment in our plans depends on contract renewal. This is a brief description of the features of this plan. Before making a final decision, please read the NALC Health Benefit Plan — High Option’s official plan brochure and the NALC High Option Plan — Aetna Medicare Advantage plan documents. All benefits under the NALC Health Benefit Plan — High Option are subject to the definitions, limitations and exclusions set forth in the official plan brochure.

SilverScript Employer PDP is a Prescription Drug Plan. This plan is offered by SilverScript Insurance Company, which has a Medicare contract. Enrollment depends on contract renewal.