North Texas and Texoma Prescription Drug Benefit Overview
2025 – Cooke, Deaf Smith, Fannin, Gray, Grayson, Moore, Potter and Randall County Drug Benefits
Standard Retail Cost-Sharing — 30-day Supply
| Plus Plan | Beyond Plan | Giveback Plan | Diabetes & Heart Plan | Extra Help Plan * | Dual Plan | |
|---|---|---|---|---|---|---|
| Prescription Drug Deductible | No Deductible | No Deductible | $300 – applies to tiers 3, 4, & 5 only | No Deductible | No Deductible | No Deductible |
| Tier 1: Preferred Generic | $0 | $0 | $0 | $0 | $0 | $0 |
| Tier 2: Generic | $12 | $15 | $15 | $15 | $0 | $0 |
| Tier 3: Preferred Brand | $45 | $47 | $47 | $45 | $0 | $0 |
| Tier 4: Non Preferred Drugs | $100 | $100 | $100 | $100 | $0 | $0 |
| Tier 5: Specialty Drugs | 33% | 33% | 33% | 28% | $0 | $0 |
| Tier 6: Specialty Drugs | $0 | $0 | $0 | $0 | $0 | $0 |
*You must have Medicare’s Extra Help to pay $0 with no deductible.
Prescriptions are also available in a 100-day supply at two copays, and through mail order.
