This tool should be used only as a guide to determine estimated charges for prescription drugs only when they are dispensed at Kaiser Permanente Pharmacies in the Kaiser Foundation Health Plan Mid-Atlantic region. This tool shows estimated charges for some commonly used prescription medicines. When prescription drugs are received from other providers such as a network pharmacy (if your plan permits prescriptions to be filled at network pharmacies) or a non-participating pharmacy in an emergency, the charges may be different.

These charges are not specific to the plan coverage that you have or are considering. The amount of charges paid out-of-pocket will depend on your plan coverage and its cost share (such as copayments, coinsurance and/or deductibles) structure, and whether or not the provider is a Kaiser Permanente Pharmacy.

This tool does not provide estimates for services provided by non-Kaiser Permanente pharmacies or facilities.

Prescription drug charges are published on a quarterly basis and are subject to change without notice. We do not guarantee the accuracy of any particular charge listed in this tool as we provide this information as an estimate only.

The information that is entered into this tool cannot be linked directly to you. Any data that you input into the tool or the calculated results are not stored on our system.

The information displayed in this tool is not an indication of whether a prescription drug will be covered under your plan. Refer to your Evidence of Coverage,Nongroup Medical and Hospital Services Agreement, or federal brochure (RI 73-047) to determine the terms and conditions pertaining to the coverage of prescription drugs under your plan and what cost share(s) you must pay.

Membership Services is available to answer your questions 7:30 a.m. to 5:30 p.m., Monday through Friday.

Washington DC area:  301-468-6000
All other areas:  1-800-777-7902
TTY:  1-301-879-6380
Language interpretation services:  1-800-777-7902
To request a Coverage Determination/ Formulary Exception:  1-866-331-2103