GW's PPO and HSP prescription benefit includes PrudentRx for specialty medications.

This program is designed to lower your out-of-pocket costs by facilitating enrollment in drug manufacturers discount co-pay cards/assistance programs. When enrolled in PrudentRx, your out-of-pocket cost will be $0 for medications included on the PrudentRx exclusive specialty drug list, which is updated monthly.

*HSP participants must meet their combined medical/prescription deductible before the out of pocket cost will be $0.

Formulary exclusions will supersede this list. If a participant’s specialty medication is not on the PrudentRx list, then the brand formulary or brand non-formulary plan design will apply.

How to Enroll in PrudentRx

Members must enroll in the PrudentRx program to access $0 copay benefits. GW PPO plan participants will be contacted via phone by CVS to enroll in PrudentRx at the time of your first specialty fill. You must complete any additional enrollment steps outlined by CVS to receive the $0 benefit. 

Please note: If you opt out, you will be responsible for the 30% coinsurance (only the amount you pay out-of-pocket will apply toward your deductible/ out of pocket maximums for essential health benefit medications).