Prescription Drug Benefits

Making sure you and your family have access to necessary medications is important to us. You are automatically enrolled in the prescription drug plan, administered by Express Scripts (ESI), if you enroll in one of the Corewell Health medical plans.

Summary of Prescription Drug Plans


Retail (30 day)
HMO Plan
HSA/POS Plan

Tier 1

$15 copay

$15 copay*

Tier 2

$50 copay

$50 copay*

Tier 3

$100 copay

$80 copay*

Tier 4 & 5

$100 copay

Tier 4: 20% up to $150*


Tier 5: 20% up to $300*

*Copayments apply after the full medical deductible on the medical plan has been met.


Mail Order (90 day)
HMO Plan
HSA/POS Plan

Tier 1

$30 copay

$30 copay*

Tier 2

$100 copay

$100 copay*

Tier 3

$200 copay

$160 copay*

Tier 4 & 5

$200 copay

Tier 4: 20% up to $300*


Tier 5: 20% up to $600*

*Copayments apply after the full medical deductible on the medical plan has been met.


Other Plan Details:  Certain contraceptive methods for women are covered at 100% under Preventive Health Services benefit. Eligible infertility drugs are available at 50% coinsurance.


Prescription drugs are sorted into tiers on our plans based on effectiveness and affordability. You can save on your prescription drug costs by filling with Tier 1 medications.


  • Tier 1: Low-cost generic drugs – proven to be as safe as brand name drugs – and select brand name drugs.
  • Tier 2: Preferred and lower-cost brand name drugs and some higher-cost generic drugs.
  • Tier 3: Non-preferred and expensive brand name drugs, as well as higher-cost generic drugs. These drugs may cost you a significant amount out-of-pocket.
  • Tier 4: Very expensive brand name and generic drugs, and preferred specialty drugs used to treat complex conditions. Specialty drugs often have high costs and may have special handling or storage requirements.
  • Tier 5: Non-preferred specialty drugs, and the most expensive brand name and generic drugs.

If you or one of your covered dependents are taking a specialty medication, you may qualify to get that medication through the Priority Health Specialty Drug Savings Program for $0! A SaveOnSP representative will reach out directly to you if you qualify.

Both medical plans offer a mail order prescription drug program through Express Scripts. You may get a three-month supply of your prescription for the cost of only two copayments, after deductible with the HSA/POS medical plan.


Visit priorityhealth.com for more information on mail order: login and access your Priority Health account. You may also contact PriorityGPS at (866) 518‑1769 or contact Express Scripts directly at (844) 586‑5349.

A rider for prescription medication related to obesity treatment is covered by our medical plans (after deductible with the HSA/POS plan). As with all other prescription medication, the medication must be on the Priority Health formulary.

Specific to the HSA/POS medical plan, this rider allows those with a Chronic Condition such as asthma, cholesterol, depression, diabetes, heart conditions and/or Osteoporosis to get certain defined medications and services prior to the deductible needing to be met, refer to your Priority Health certificate of coverage for additional details.

On the HMO Plan: Prescription drugs are available for a copay regardless of whether you have reached your deductible.


On the HSA/POS Plan: You will pay prescription drugs costs out of pocket until you reach your medical plan deductible. After that point you will pay the above costs.