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PrudentRx can be reached at 1-800-578-4403 to address any questions regarding the PrudentRx Solution. The PrudentRx Program Drug List may be updated periodically. Payments made on your behalf, including amounts paid by a manufacturer’s copay assistance program, for medications•Step Two: You need to call PrudentRx at 1-800-578-4403 within the next 5-days to register for any copay assistance. available from drug manufacturers. It is essential to complete step two and become fully enrolled to avoid being opted out of the program. 1-800-578-4403 Monday–Friday 8am to 8pm EST prudentrx.com PAGE2OF2Please verify with PrudentRx at 1-800-578-4403. 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Note that if you don’t use the PrudentRx program, you’ll pay 30% coinsurance for eligible specialty medication. • 800 w/WH or $2,400 Others 1,000 w/WH or $3,000 Others Coinsurance Plan Pays / You Pay 100% / 0% 80% / 20% Out-of-Pocket Max (including deductible, copay & coinsurance) ... to start any copay assistance available or you can call PrudentRx at 800-578-4403. Price Comparison Tools***Call 1-800-578-4403 for more information about your Specialty Drug costs. Created Date: 11/3/2020 2:37:28 PM ...can be reached at 1-800-578-4403 to address any questions regarding the PrudentRx solution. Preferred brand drugs $30 copay / retail prescription $60 copay / mail-order prescription $30 copay plus remaining balance after pharmacy is paid at network rate Preferred multisource brand drugs $22 copay / retail prescription $44 copay / mail-orderIf you take a specialty medication, you must enroll by calling PrudentRx at 800-578-4403 Monday through Friday from 8:00 a.m. to 8:00 p.m. ET. 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Phone: +1 800 578 4403 My Benefits Service Center COBRA Administrator For election forms and premium payments: My Benefits Service Center P.O. Box 2672 Omaha, NE 68108-2672 For all other correspondence: My Benefits Service Center P.O. Box 350 Conshohocken, PA 19428 Phone: +1 866 324 4087, any business day, 8:30 a.m. to 5:30 …PrudentRx at 1-800-578-4403. You pay 100%. Plan reimburses no more than it would have paid had you used an In-Network Retail pharmacy. Deductible does not apply. • Specialty drugs require preauthorization by calling CVS Specialty Pharmacy at 1-866-387-2573. For most specialty drugs, the contracted specialty drug mail-order pharmacy is required.You can also contact them directly at 1-800-578-4403. You can choose to opt-out at any time. Not all specialty prescriptions offer assistance. PrudentRx will also contact you if you are required to enroll in the copay assistance for any medication that you take. 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