Prescription Drug Lookup
2023 Drug Search - See if your drug is covered
Click here to search the 2023 Shell KelseyCare Advantage Prescription Drug Formulary
2023 Schedule of Copayments for Prescription Drugs
Your pharmacies with preferred cost-sharing include Kelsey Pharmacies, H-E-B, CVS retail pharmacies and CVS Mail Service Pharmacy. If you fill your prescription at these pharmacies, you may pay lower cost sharing than at other pharmacies.
Preferred Retail and Mail Order Pharmacies |
Tier |
30-Day Supply |
60-Day Supply |
90-Day Supply |
1 |
$0 |
$0 |
$0 |
2 |
$0 |
$0 |
$0 |
3 |
$40 |
$80 |
$100 |
4 |
$80 |
$160 |
$200 |
5 |
31% |
31% |
31% |
6 |
$0 |
$0 |
$0 |
* Important Message About What You Pay for Insulin - You won’t pay more than $35 for a one-month supply of each insulin product covered by our plan, no matter what cost-sharing tier it’s on.
Standard Retail Pharmacy (Non-Preferred) |
Tier |
30-Day Supply |
60-Day Supply |
90-Day Supply |
1 |
$3 |
$6 |
$9 |
2 |
$15 |
$30 |
$45 |
3 |
$45 |
$90 |
$135 |
4 |
$90 |
$180 |
$270 |
5 |
31% |
31% |
31% |
6 |
$0 |
$0 |
$0 |
* Important Message About What You Pay for Insulin - You won’t pay more than $35 for a one-month supply of each insulin product covered by our plan, no matter what cost-sharing tier it’s on.
If you reside in a long-term care facility, you pay the same as at a retail pharmacy. You may get drugs from an out of network pharmacy but may pay more than you pay at an In-Network pharmacy.