Pharmacy Benefits
Easy and affordable prescriptions for as little as $4.
All our medical plans include pharmacy benefits, with low-cost generics available at Walmart and Sam’s Club pharmacies.

Prescriptions you can afford.

$4_generics

$4 generics
 

Generic prescription
medications are available
for just $4.

Preventive__care

Preventive care
 

Preventive medications are
covered with fixed
or zero copays.

Network_only

Network only
 

With most plans, you’ll pay full price
if you use a pharmacy other than
Walmart or Sam’s Club.

Walmart or Sam’s Club only—with exceptions

If you’re in the Premier, Contribution, Saver, or a Local Plan, you must use a Walmart or Sam's Club pharmacy to get your pharmacy benefit. All other pharmacies are considered out-of-network, and in most cases you'll pay the full retail price.
If there isn’t a Walmart or Sam's Club pharmacy within five miles of where you work, you'll also be able to use your benefit at any OptumRx network pharmacy unless you’re enrolled in a Local Plan.

What plans are included?
  • PremierContribution, and all Local Plans: The benefits shown here are automatically included.
  • Saver Plan: Due to IRS rules, you must pay full price for most prescriptions until you meet your annual deductible. After that, you’ll get the benefits shown here. However, you can get some preventive medications for just a copay without meeting your deductible.
  • PPO Plan: Prescriptions start at $10 for generic drugs, as shown below. In this plan, you can use any Aetna pharmacy.
  • HMO plans: All HMOs include prescription benefits, which typically start at $10 for generic drugs. Ask your People Partner or contact your plan directly for details.
What drugs are covered?

To be eligible, drugs must be on Walmart's formulary list. This list is maintained by OptumRx. It’s reviewed quarterly and often changes. You can also call OptumRx at 844-705-7493 to ask about a particular drug. For the PPO Plan, you'll find the formulary here: www.aetnapharmacy.com/premier.

 

Some brand-name and other prescription drugs aren’t covered because generic, or over-the-counter alternatives have proven to be just as effective. For more information about what is and is not covered, see the “Pharmacy Benefit” section of the Associate Benefits Book.

Mail order

When you pick up a prescription at a Walmart or Sam’s Club pharmacy, each copay covers up to a 30-day supply. If you take a medication regularly and order it by mail, you’ll pay three times this cost and receive a 90-day supply.

Specialty drugs

All specialty drugs under the Premier, Contribution, Saver, and Local Plans must be purchased through a Walmart Specialty Pharmacy or OptumRx Specialty Pharmacy. If a specialty drug is purchased from another retail pharmacy, it will not be covered under the plan. You should call a Walmart Specialty Pharmacy or OptumRx Specialty Pharmacy to ask about the availability of your prescription drugs under the plan.

Medicare coverage

If you’ll be eligible for Medicare soon, you should know that Walmart's prescription drug benefit has been determined to be “creditable coverage” as defined by Medicare, except for the Saver Plan. That means that on average it's expected to pay as much as, or more than, a standard Medicare drug plan.

 

If you later decide to join a Medicare drug plan, having “creditable coverage” under the Walmart plan will keep you from paying a higher premium under Medicare. For more information, see the Medicare Part D notice (PDF).

entries


Here’s your cost for prescriptions, depending on the plan you choose. Each copay covers up to a 30-day supply.

  Premier Plan, Contribution Plan, Local Plans Saver Plan PPO Plan
Generic drugs $4 copay $4 copay after deductible $10
Brand-name drugs* 25% of allowed cost* or $50, whichever is greater 25% of allowed cost* or $50, whichever is greater $30
Specialty drugs 20% of allowed cost* or $50, whichever is greater 20% of allowed cost* or $50, whichever is greater, after deductible $60

*The allowed cost of prescription drugs is determined by OptumRx.

Easy home delivery
You can get eligible prescriptions by mail through Walmart Home Delivery Pharmacy. Your cost for a 90-day supply is three times the cost of a 30-day supply as shown above.

More resources

Downloads

See the 2022 Associate Benefits Book for more information about your benefits and eligibility. This document will control in the event of any conflict. If you're looking for the 2020 Associate Benefits Book with 2021 Summaries of Material Modifications, you'll find it here.

Need help?

Call People Services at 800-421-1362.

Contacts