Get prescriptions

WellSense is committed to providing quality and affordable medications for Massachusetts members through our prescription drug benefit.

Check drug coverage

Find out if your medication is covered and what your cost (or copay) will be.  

Price a medication

Find a pharmacy
Pick up your prescriptions at a pharmacy near you.

Find a pharmacy

Our prescription drug benefit offers:

  • Coverage of thousands of medications
  • Coverage of nondrug pharmacy items
  • Coverage of some over-the-counter drugs like aspirin or certain allergy medicines
  • Affordable copays for generic medications
  • Choose from more than 1,000 chain and independent retail pharmacies throughout Massachusetts to get prescriptions filled, or get certain prescriptions mailed to your home through our mail order program.
  • Medications for members with rare or chronic health conditions. Providers may obtain injectables and biotech drugs through our specialty pharmacy networks.

Drug costs

2025 WellSense Clarity plan drug costs

Understanding drug tiers for your plan

When searching for a drug, pay attention to the drug tier listed next to it to find your copay cost. If no tier is listed, there may be a restriction on that particular drug, and you may need to try another medication first. In some cases, your doctor needs to ask us for approval to prescribe you a medication before we can cover it. Find your plan type below to see the cost for each drug tier. "SG" plan members should choose the metallic name (Silver, Gold, etc.) that matches their plan.

You can also view your prescription costs in the Prescription Drug section of the Schedule of Benefits.

Retail prescriptions (1-month supply)
Plan name Tier 1 generic drugs Tier 2 preferred brand drugs Tier 3 non-preferred brand & specialty drugs

ConnectorCare 1

 $0 $0 $0

ConnectorCare 2

 $10 $20 $40
ConnectorCare 3 $12.50 $25 $50
Platinum 0 Deductible $10 $25 $50
Gold 1000 $25 $45 $75 after deductible
Gold 1500 $30 $60 after deductible $90 after deductible
Silver 2000 $30 $55 $75 after deductible
Silver 2000 II  $30 $55 $75 after deductible
Silver 3000 $30 after deductible 35% after deductible 35% after deductible
Bronze HSA 3600 $30 after deductible $120 after deductible $200 after deductible
AIAN Zero & Limited Cost Share  $0 $0 $0

 

Mail-order prescriptions (3-month supply)
Plan name Tier 1 generic drugs Tier 2 preferred brand drugs Tier 3 non-preferred brand & specialty drugs

ConnectorCare 1

 $0 $0 $0

ConnectorCare 2

 $20 $40 $80
ConnectorCare 3 $25 $50 $100
Platinum 0 Deductible $20 $50 $150
Gold 1000 $50 $90 $225 after deductible
Gold 1500 $60 $120 after deductible $270 after deductible
Silver 2000 $60 $110 $225 after deductible
Silver 2000 II  $60 $110 $225 after deductible
Silver 3000 $60 after deductible 35% after deductible 35% after deductible
Bronze HSA 3600 $60 after deductible $240 after deductible $600 after deductible
AIAN Zero & Limited Cost Share $0 $0 $0

 

2024 WellSense Clarity plan drug costs

Understanding drug tiers for your plan

When searching for a drug, pay attention to the drug tier listed next to it to find your copay cost. If no tier is listed, there may be a restriction on that particular drug, and you may need to try another medication first. In some cases, your doctor needs to ask us for approval to prescribe you a medication before we can cover it. Find your plan type below to see the cost for each drug tier. "SG" plan members should choose the metallic name (Silver, Gold, etc.) that matches their plan.

You can also view your prescription costs in the Prescription Drug section of the Schedule of Benefits.

Retail prescriptions (1-month supply)
Plan name Tier 1 generic drugs Tier 2 preferred brand drugs Tier 3 non-preferred brand & specialty drugs

ConnectorCare 1

 $1 $3.65 $3.65

ConnectorCare 2

 $10 $20 $40
ConnectorCare 3 $12.50 $25 $50
Platinum 0 Deductible $10 $25 $50
Gold 0 Deductible $30 $60 $90
Gold 1500 $30 $60 after deductible $90 after deductible
Silver 2000 $30 $55 $75 after deductible
Silver 2000 II  $30 $55 $75 after deductible
Silver 3000 $30 after deductible 35% after deductible 35% after deductible
Bronze HSA 3600 $30 after deductible $120 after deductible $200 after deductible
AIAN Zero & Limited Cost Share  $0 $0 $0

 

Mail-order prescriptions (3-month supply)
Plan name Tier 1 generic drugs Tier 2 preferred brand drugs Tier 3 non-preferred brand & specialty drugs

ConnectorCare 1

 $2 $7.30 $7.30

ConnectorCare 2

 $20 $40 $80
ConnectorCare 3 $25 $50 $100
Platinum 0 Deductible $20 $50 $150
Gold 0 Deductible $60 $120 $270
Gold 1500 $60 $120 after deductible $270 after deductible
Silver 2000 $60 $110 $225 after deductible
Silver 2000 II  $60 $110 $225 after deductible
Silver 3000 $60 after deductible 35% after deductible 35% after deductible
Bronze HSA 3600 $60 after deductible $240 after deductible $600 after deductible
AIAN Zero & Limited Cost Share $0 $0 $0

 

Members may be exempt from paying a copay for the following reasons:

  • The member is receiving family planning supplies and/or family planning services
  • The member has met the annual out-of-pocket maximum when applicable

Each member has an out-of-pocket maximum based on the member's plan type. Once the annual out-of-pocket maximum is reached, you will no longer be required to contribute towards the cost of your prescriptions. You can find your yearly out-of-pocket maximum in your Schedule of Benefits. You can log in to the member portal to find the cost of a specific drug.

Glossary

Generic drugs: You will pay the lowest copay for generic drugs. Generics are equivalent to their brand-name counterparts, and are ensured by the Food and Drug Administration to be as safe and effective.

Preferred brand drugs: These are drugs covered by your pharmacy benefit when generic equivalents are not available.

Non-preferred brand drugs: These are brand-name drugs that are not covered under your pharmacy benefit but may be covered if they are a part of your medical benefit, another preferred drug is tried first, or prior approval is obtained