Prescription Plan
Each of the medical plans include prescription drug coverage that corresponds with your medical plan election.
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Click any button below for plan materials and resources.
Anthem: How Much You Pay for Prescription Drugs
Prescription drugs are grouped into three tiers, based on a drug’s effectiveness and affordability.
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Tier 1: The drugs in this tier cost you the least. They’re usually generic drugs. Generic drugs have the same active ingredients and effectiveness as their brand-name equivalents and meet FDA standards for safety and quality.
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Tier 2: The drugs in this tier cost you more than Tier 1 drugs. They may be preferred brand drugs, based on how they work and how much they cost compared to other drugs used to treat the same conditions. They may also be generic drugs if those drugs are new to the pharmaceutical market.
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Tier 3: The drugs in this tier cost you the most of the three tiers. They often include non-preferred brand and generic drugs. And they may include drugs that were recently approved by the FDA, or specialty drugs used to treat a serious, long-term health condition.
Maintenance Medications
If you take maintenance medications—prescriptions used long-term for conditions like high blood pressure or high cholesterol— you are required to have these medications filled:​
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Through Carelon mail order, or ​
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As a 90-day supply at a CVS pharmacy.
If not filled through one of these options, you may be responsible for the full cost of the medication.
Call Anthem’s mail-order service 24/7 at 1-833-263-2858 or visit the Sydney app to get started.
Anthem Members Pay $0 For Otsuka Prescription Drugs
As an Otsuka employee, you enjoy the benefit of paying $0—no copayment, no deductible, no coinsurance—for any Otsuka-US-branded drug if you’re covered under the Premier Plan or the Choice Plan. If you’re covered under the Consumer Plan, you pay $0 after meeting the plan’s annual deductible.
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Review the 2025 Otsuka Custom Prescription Drug list to see where you can save.
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For the most up-to-date information, log in at anthem.com/ca, and choose Pharmacy.
NOTE: The approval process for GLP-1 drugs under the Otsuka Plan (e.g. GLP-1 agonist medications for weight loss including Wegovy and Saxenda) requires prior authorization if certain conditions are met. For additional information, please contact Anthem at 1-833-263-2858.
The following drugs are eligible for savings under the Anthem plans:
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Otsuka Group Branded Drugs
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Abilify Asimtufii
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Abilify Maintena
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Abilify MyCite
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Abilify Tablets
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Dacogen
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Inqovi
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IV Busulfex
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Jynarque
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Lonsurf
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Nuedexta
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Rejoyn
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Rexulti
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Samsca
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VOYXACT
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Otsuka Collaborations​
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Balversa
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Kisqali
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Kisqali & Femara​
Benefits Eligibility
You’re eligible to participate in the Otsuka benefits program if you are a regular, full-time employee or a part-time employee scheduled to work at least 15 to 30 hours per week.
Eligible Dependents
You may enroll your eligible dependents for certain levels of benefit coverage. Eligible dependents include:
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Your spouse or domestic partner
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Your children or your domestic partner’s children, up to age 26
If you’re enrolling anyone other than yourself, you may be required to provide proof of their eligibility. You may not enroll any dependents without enrolling yourself in Otsuka’s plans.
