| Beneficio de Farmacia |
| Platino |
$0-$1,000: copagos y coseguros aplicables; $1,001+: 60% coseguro |
| Gold 1 |
$0-$800: copagos y coseguros aplicables; $801+: 80% coseguro |
| Platino POS |
$0-$1,000: copagos y coseguros aplicables; $1,001+: 60% coseguro |
| Gold POS |
$0-$1,000: copagos y coseguros aplicables; $1,001+: 80% coseguro |
| Genérico Bioequivalente |
| Platino |
$5 de $0-$1,000 |
| Gold 1 |
$5 de $0-$800 $801+ |
| Platino POS |
$5 de $0-$1,000 $1,001+ |
| Gold POS |
$10 de $0-$1,000 $1,001+ |
| Marca Preferida |
| Platino |
20% min $20 de $0-$1,000, $1,001+ 60% |
| Gold 1 |
25% de $0-$800, $801+ 80% |
| Platino POS |
20% min $20 de $0-$1,000, $1,001+ 60% |
| Gold POS |
25% min $20 de $0-$1,000, $1,001+ 80% |
| Marca no Preferida |
| Platino |
30% min $30 de $0-$1,000, $1,001+ 60% |
| Gold 1 |
50% de $0-$800, $801+ 80% |
| Platino POS |
30% min $30 de $0-$1,000, $1,001+ 60% |
| Gold POS |
50% min $30 de $0-$1,000, $1,001+ 80% |
| Productos Especializados |
| Platino |
50% de $0-$1,000, $1,001+ 60% |
| Gold 1 |
50% de $0-$800, $801+ 80% |
| Platino POS |
50% de $0-$1,000, $1,001+ 60% |
| Gold POS |
50% de $0-$1,000, $1,001+ 80% |
| Over-the-Counter (OTC) medications |
| Platino |
$1 |
| Gold 1 |
No Cubierto |
| Platino POS |
No Cubierto |
| Gold POS |
No Cubierto |