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RegenceRx Pharmacy

Three Things To Know When Choosing a Prescription Medication Benefit:

  1. We have three basic kinds of prescription medication benefits:
    • Three-tier coinsurance (flat copay or percentage of cost)
    • Three-tier copay (flat copay)
    • Closed formulary (no non-formulary medications)


  2. Under each of these benefits, there are three categories of medications:
    • Generic formulary
    • Brand-name formulary
    • Non-formulary


  3. All the benefits use a Preferred Medication List/Formulary (PML), which is a list of covered medications. An outside committee of local physicians and pharmacists creates and maintains the formulary (meaning, Regence BlueShield has no say over what drugs are on the formulary). The committee chooses drugs based on clinical studies for relative effectiveness, safety and health outcomes. View our Preferred Medication List/Formulary, located on the RegenceRx Web site.

What Your Employees Will Pay at the Pharmacy:

Your employees will have to pay some amount for each covered prescription they fill under any of these benefits. The amount they pay depends on two things:

  • What benefit you choose
  • Which medication they choose

Use our RegenceRx pharmacy search to locate a participating pharmacy near you.

Your Prescription Medication Options:

The table below provides an overview of the prescription medication options available to you.

Three-Tier Coinsurance Benefit Three-Tier Copay Benefit Closed Formulary Benefit
Offers greater choice by covering formulary and non-formulary medications at varying levels. Offers greater choice by covering formulary and non-formulary medications at varying copays. Benefits limited to formulary medications without approval.
Out-of-pocket expense varies: fixed copay for generic medications and coinsurances for brand-name formulary and non-formulary medications. Also has a $2,400 prescription-medication stoploss. Out-of-pocket expense (copay) is lowest for generic formulary medications and highest for non-formulary medications. Out-of-pocket expense is limited to one copay or coinsurance.
Mail-order service available. Mail-order service available. Mail-order service available.
Formulary is an important tool. Formulary is an important tool. Formulary is an important tool.
Non-formulary medications require higher out-of-pocket expense. Non-formulary medications require higher out-of-pocket expense. Non-formulary medications covered only if doctor or pharmacist obtains approval from Regence BlueShield.
Choice between a $7/30%/50% option and a $12/30%/50% option. $10/$20/$40 option available. Copay options: $15 or $20.
Coinsurance options: member pays 50% to $2,000 per-member annual maximum; or member pays 20% with $500 per-member deductible and no annual maximum. (only available to renewing groups who currently have this benefit)
Download Summaries of Benefits Download Summaries of Benefits Download Summaries of Benefits


If you'd like to find out more about a specific plan, or would like a quote for your group, please request additional plan information.