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Prescription Drug Benefits SummaryBENEFIT TRS-ACTIVECAREPRIMARYDrug Deductible(per person, per plan year)Integrated with medicalMOOP Integrated with medicalShort-Term Supply (up to a 31-day supply)Generic $15 copay, $0 copay for certain genericsPreferred Brand 30% coinsurance after deductibleNon-Preferred Brand 50% coinsurance after deductibleInsulin Out-of-Pocket Cost $25 copayLong-Term Supply (61- to 90-day supply)Generic $45 copay, $0 copay for certain genericsPreferred Brand 30% coinsurance after deductibleNon-Preferred Brand 50% coinsurance after deductibleFormulary Insulin Out-of-Pocket $75 copaySpecialty Medications through Accredo (up to a 31-day supply)Specialty Medications 30% coinsurance after deductibleSpecialty Medications through SaveOnSP copay assistance programSpecialty Medications on the SaveOnSP Drug List $0 copayDiabetic Meter and SuppliesMETER AND SUPPLIESTRS-ACTIVECARE PRIMARYPreferred Brand Blood Glucose Meter $0SuppliesCopays waived for all needles, lancets and syringes, regardless of the brand. To get test strips at no cost, you must use the preferred brand. Coinsurance applies after deductible.Prescription Answers and Information Online 24/7 Once you enroll in TRS-ActiveCare, register with Express Scripts at www.express-scripts.com/trsactivecare. Log in anytime to fill or refill long-term prescriptions, find drug coverage and price information, talk with a registered pharmacist, view your prescription history, download the Express Scripts app and much more.Save Money with Mail OrderYou can avoid paying this convenience fee if you fill your long-term maintenance drugs (up to a 90-day supply) with Express Scripts.32 www.bcbstx.com/trsactivecare