• Tier 1: Generic drugs
• Tier 2: Preferred brand-name drugs
• Tier 3: Non-preferred brand-name drugs
• Specialty: Specialty drugs

In general, lower-tier drugs cost less than higher-tier drugs. Your cost share is based on the drug tier and the medical plan you’re enrolled in.

• Core and Plus HDHPs: Prescription drugs are subject to the combined medical and prescription drug deductible and out-of-pocket maximum.
• PPO: Deductible does not apply. You’ll pay a copay or coinsurance depending on the drug tier.

If you take a maintenance drug for an ongoing condition, you may be able to save money by filling a 90-day supply through OptumRx’s mail-order program or a CVS retail pharmacy. To have your prescription delivered by mail, create your account on optumrx.com and order directly from the site.

Your medical plan uses management programs to help ensure safe, effective, and cost-conscious use of drugs.

Step therapy requires the use of clinically proven, lower-cost drugs before covering more expensive alternatives.

Prior authorizations may be required for certain brand-name drugs. If a generic equivalent is available and you choose a brand-name drug, you may be responsible for the cost difference in addition to your regular cost share. This cost difference does not count toward your deductible or out-of-pocket maximum. After submitting a prior authorization request, you and your provider will receive a notification letting you know whether the request was approved or denied. Approval notifications will include the authorization period, which is typically 6 or 12 months. If a request is denied, the notification will explain why and outline the next steps available to you and your provider.

Twin Health offers personalized support for managing your weight and creating healthy habits. If you’re prescribed a GLP-1 for weight loss, Twin Health program participation is required for your prescription to be covered. Visit the Twin Health website or download its mobile app to learn more. Participation is not required if you’re prescribed a GLP-1 for diabetes or another complex condition.

With 24/7 NurseLine, you and your covered family members can speak with a registered nurse anytime, day or night, at no additional cost. Whether you’re dealing with a fever, allergies, a new symptom, or an unexpected health concern, a nurse can help assess your symptoms and guide you to the most appropriate level of care. They can also answer general health questions, help you find doctors, hospitals, and specialists, and connect you with available health management programs and resources.

Call the 24/7 NurseLine at 800-700-9184 whenever you need guidance or aren’t sure where to go for care.

When you’re facing a new diagnosis, considering surgery, exploring treatment options, or managing a chronic condition, 2nd.MD can help you make informed decisions about your care. You’ll have access to board-certified specialists across the country who can review your situation, explain your options, answer questions, and provide an expert second opinion by phone or video. The service is designed to help you feel more confident about your treatment plan and next steps.

To get started, visit 2nd.MD’s website.

Whether you’re planning for a family, expecting a child, or raising young children, Building Healthy Families provides personalized support for every stage of the journey. The program includes resources for pregnancy, adoption, surrogacy, single parenthood, and early childhood development.

You’ll have access to educational articles and videos, personalized pregnancy and parenting content, health trackers, and support from Family Care Coaches. The program can also connect you with maternity nurse support and virtual lactation services during pregnancy and after your baby arrives.

To get started, log in to your account through Anthem’s website or via the Sydney Health mobile app.

If you’re living with obesity, diabetes, hypertension, or kidney or heart disease, Twin Health provides personalized support to help you better manage your health. Eligible members receive access to a dedicated care team, 24/7 specialist support, lab testing, real-time health monitoring, and the Twin Health app, which brings everything together in one place. You’ll also receive a Twin Kit that may include connected devices such as a continuous glucose monitor, smartwatch, smart scale, and blood pressure cuff to help you track your progress and stay connected to your care team.

Visit our Twin Health website or download the Twin Health mobile app to get started.

If you’re prescribed a GLP-1 for weight loss, Twin Health program participation is required for your prescription to be covered under an Anthem medical plan.

Whether you’re recovering from an injury, getting ready for surgery, dealing with back or joint pain, or simply trying to stay active, Hinge Health gives you access to virtual musculoskeletal (MSK) care from home, on your schedule. Depending on your needs, support may include a dedicated care team and one-on-one physical therapy. The program is available to all employees and dependents ages 18+ who are enrolled in an Anthem medical plan.

Visit the Hinge Health website or download the Hinge Health mobile app to get started.

For more information about Anthem tools and resources, see our program flyers on the Resources page.

You may be eligible for the TRICARE Supplement Plan if you’re enrolled in TRICARE and are:

• A military retiree entitled to retired pay
• The spouse or surviving spouse of an eligible military retiree
• A retired Reservist or National Guard member
• The spouse or surviving spouse of an eligible retired Reservist or National Guard member

Additional eligibility rules may apply based on age, Medicare eligibility, TRICARE enrollment status, and place of residence. To learn more, see the TRICARE Supplement Plan flyer on the Resources page.

See page 13 of the 2027 Benefits Guide to see how your dental plan options compare.

You can visit any dentist you choose, but using an in-network provider can help you save money. Delta Dental offers two network options:

• Delta Dental PPO dentists typically provide the lowest cost for care.
• Delta Dental Premier dentists are also in-network but may cost more than PPO providers.

To find a network provider, register on Delta Dental’s website or via the Delta Dental mobile app. You’ll need to provide both your Delta Dental-assigned ID number and your social security number. If you don’t have your ID card handy, you can call our Benefit Services Department at 800–237–6060 for help.

If you see an out-of-network dentist, you’ll likely need to pay for services in full and get reimbursed from the plan later. You’ll pay your deductible and coinsurance, plus any charges above Delta Dental’s contracted rates. Some out-of-network dentists may file claims for you, while others may require you to do it.

Once you enroll, physical ID cards will be mailed to your home address listed in Workday. Digital ID cards are also available in the Delta Dental mobile app.