Prescription Base Plan Deductible Examples
Burlington Township School District

 

Your Prescription Base Plan deductible based on plan year July 1 through June 30 is:

**Individual = $50
**Family = $100 ($50 maximum per family member up to $100)

Example 1:
Your first prescription of the plan year (July 1 through June 30) is a Preferred Brand-Name drug; the total drug cost is $100:

**You pay your deductible of $50
**You also pay your Preferred Brand-Name copay of $30
**BeneCardPBF covers the remaining $20

For the remainder of the plan year, you pay the applicable copay per prescription since you have met your yearly deductible.

Example 2:
Your first prescription of the plan year (July 1 through June 30) is a Preferred Brand-Name drug; the total cost is $25:

**You pay $25 towards the yearly deductible

Your second prescription of the plan year is a Generic drug; the total drug cost is $5:

**You pay $5 towards the yearly deductible

Your third prescription is a Preferred Brand-Name drug; the total drug cost is $55:

**You pay the remaining $20 towards the yearly deductible
**You pay the Preferred Brand-Name copay of $30
**BeneCardPBF pays the remaining $5

For the remainder of the plan year, you pay the applicable copay per prescription since you have met your yearly deductible.