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Prescription coverage

Prescription coverage is included with all of our medical plans

How it works
Locations
Choose from 30+ outpatient pharmacies, a dedicated specialty pharmacy, 24/7 kiosks or from our nationwide contracted network. You'll save money when you use a BSW pharmacy!

Have an ongoing maintenance medication? Skip the store and use mail-order!

Download the Pharmacy Mail Order Form here.
Tax-free savings accounts
SEQA/EQA or PPO plan enrollees may use funds from a general-purpose Flexible Spending Account (FSA) to pay for prescription drugs and over-the-counter drugs prescribed by a physician.

HSA Plan enrollees may use their Health Savings Account (HSA) to pay for prescription expenses.

See more details about the tax-free savings accounts.
SEQA/EQA and PPO Plans
With the SEQA, EQA or PPO Plans, you pay copays or coinsurance from day one.

With the SEQA Plan, select diabetic medicine and supplies are covered at no cost!
HSA Plan
With the HSA Plan, pharmacy costs count toward your deductible or coinsurance up until the out-of-pocket maximum is met.
Drug Coverage
Our Group Value Formulary includes drugs covered under your plan and is approved by BSW physicians and healthcare providers. Drugs not listed on the formulary require prior authorization. You, a representative or your doctor may submit a request for coverage.

Download BSWH Group Value Formulary list.
Prior authorization
Some drugs need approval before the plan will cover them, for safety and cost reasons. If you fill a prescription for a brand name drug when a generic is available, prior authorization will be required for coverage of the drug at the applicable non-preferred or specialty copay.

Download Drug Requests - Prior Authorizations, Exceptions and Appeals.

Deeper Dive

SWHP pharmacy forms

  • BSW pharmacies save you money!

    • 20% discount on over-the-counter medications with your badge

    • 90-day supply prescriptions for maintenance eligible drugs are available for the cost of only two copays, either in-store or through mail order
       
    • 30-day supplies of preferred generics are $3 at a BSW pharmacy vs. $10 at a contracted pharmacy

Looking for additional pharmacies?

Search for all SWHP contracted pharmacies.

  • SEQA/EQA plan enrollees
  • PPO and HSA plan enrollees

SEQA/EQA plan enrollees

Select "Pharmacy" from the "All Specialties" drop-down menu

PPO and HSA plan enrollees

Select "Pharmacy" from the "All Specialties" drop-down menu

This site summarizes the programs and benefits available to employees and their eligible dependents. Official plan documents, policies and certificates of insurance that contain the details, conditions, maximum benefit levels and restrictions on benefits govern our benefits program and are available on this site. In case of a conflict between this site and the official documents, the official documents prevail. The information on this site isn't a guarantee of benefits. Baylor Scott & White reserves the right to modify or terminate its employee benefit plans and programs at any time for any reason.

Click here if you have feedback on the website or need to report an issue. All other questions and issues, please contact the corresponding resource on the Need Help page.

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