THE COMPETITOR RX-PAY CARD

Prescription Discount Program

This program is designed to educate you on the use of generic and other low-cost brand name drugs. This program is designed to help you find medications within the same therapeutic class as a drug you may currently be taking. Most of all, this plan is designed to Save You Money on your prescription drug costs..

Special Features...

• Available nationwide at over 42,000 pharmacies
• Convenient Internet enrollment for instant coverage
• Formulary program with 4 tiers (see below) - then below the features have the breakdown of the tiers illustrated.
• Automatic Acceptance - no underwriting or health questions
• No time limits for pre-existing conditions
• No monthly or annual maximums

This formulary program has the following tiers:

• The first tier is generic drugs that will be available to you for a payment of up to $10.00.
• The second tier is brand name drugs and select generic drugs that will be available to you for a payment of up to $20.00.
• The third tier is brand name drugs and select generic drugs that will be available to you for a payment of up to $50.00.
• The fourth tier is brand name drugs that we have negotiated a special discount price for you.

BROCHURE & APPLICATION

Brochure & Application:
List Bill Form:
List of Drugs & Pharmacy:

Managed by:  Rx Options, Inc.
Administered by:  HPA, Inc.