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Prescription Benefit Summaries: Personal Choice — HCR 100% Preventive Options: Groups 51+IBC Forms Online
The Prescription Benefit Summaries: Personal Choice section provides a comprehensive list of Independence Blue Cross prescription benefit summaries for you to access. Select the desired plan to view the available benefits summaries.
Forms are in pdf format.
| Option | Last Updated |
|---|---|
| 0% | 2011-06 |
| $10/$15 | 2011-06 |
| $10/$20 | 2011-06 |
| $2/$6 | 2011-06 |
| $4/$8 | 2011-06 |
| $ 4 | 2011-06 |
| 50% | 2011-06 |
| $5/$10 | 2011-06 |
| $5/$20 | 2011-06 |
| $6/$10 | 2011-06 |
| $7/50%/$125 Max PPO Standard Drug | 2011-06 |
| $7 Generic/50% with $250 Max Brand PPO Standard Drug | 2011-06 |
| $ 7 Generic Only/Brand Discount PPO Standard Drug | 2011-06 |
