Get prescriptions

WellSense is committed to providing quality and affordable medications for New Hampshire Clarity plan members through our prescription drug benefit.

Check drug coverage

Click below to find out if your medication is covered and what your cost (or copay) will be, or search the list of covered drugs. 

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 New Hampshire 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

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. 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 drugs Tier 4 specialty drugs
WellSense Clarity NH Bronze 6500  25% after deductible 35% after deductible 40% after deductible 40% after deductible
WellSense Clarity NH Bronze 6500 AIAN $0 $0 $0 $0
WellSense Clarity NH Bronze 7300 HSA 0% after deductible 0% after deductible 0% after deductible 0% after deductible
WellSense Clarity NH Bronze 7300 HSA AIAN $0 $0 $0 $0
WellSense Clarity NH Bronze 7500  $25 $50 after deductible $100 after deductible $500 after deductible
WellSense Clarity NH Bronze 7500 AIAN $0 $0 $0 $0
WellSense Clarity NH Silver 0 Deductible  40% 40% 55% 55%
WellSense Clarity NH Silver 0 Deductible AIAN $0 $0 $0 $0
WellSense Clarity NH Silver 0 Deductible Core 1 40% 40% 55% 55%
WellSense Clarity NH Silver 0 Deductible Core 2 40% 40% 55% 55%
WellSense Clarity NH Silver 0 Deductible Core 3 40% 40% 55% 55%
WellSense Clarity NH Silver 5000  $20 $40 $80 after deductible $350 after deductible
WellSense Clarity NH Silver 5000 AIAN $0 $0 $0 $0
WellSense Clarity NH Silver 5000 Core 1 $0 $15 $50 $150
WellSense Clarity NH Silver 5000 Core 2 $10 $20 $60 after deductible $250 after deductible
WellSense Clarity NH Silver 5000 Core 3 $20 $40 $80 after deductible $350 after deductible
WellSense Clarity NH Silver 5800  $20 $40 $80 after deductible $350 after deductible
WellSense Clarity NH Silver 5800 AIAN $0 $0 $0 $0
WellSense Clarity NH Silver 5800 Core 1 $20 $30 $80 $350
WellSense Clarity NH Silver 5800 Core 2 $20 $30 $80 after deductible $350 after deductible
WellSense Clarity NH Silver 5800 Core 3 $20 $40 $80 after deductible $350 after deductible
WellSense Clarity NH Gold 1500 $15 $30 $60 $250
WellSense Clarity NH Gold 1500 AIAN $0 $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  drugs
WellSense Clarity NH Bronze 6500  25% after deductible 35% after deductible 40% after deductible
WellSense Clarity NH Bronze 6500 AIAN $0 $0 $0
WellSense Clarity NH Bronze 7300 HSA 0% after deductible 0% after deductible 0% after deductible
WellSense Clarity NH Bronze 7300 HSA AIAN $0 $0 $0
WellSense Clarity NH Bronze 7500  $62.50 $125 after deductible $250 after deductible
WellSense Clarity NH Bronze 7500 AIAN $0 $0 $0
WellSense Clarity NH Silver 0 Deductible  40% 40% 55%
WellSense Clarity NH Silver 0 Deductible AIAN $0 $0 $0
WellSense Clarity NH Silver 0 Deductible Core 1 40% 40% 55%
WellSense Clarity NH Silver 0 Deductible Core 2 40% 40% 55%
WellSense Clarity NH Silver 0 Deductible Core 3 40% 40% 55%
WellSense Clarity NH Silver 5000  $50 $100 $200 after deductible
WellSense Clarity NH Silver 5000 AIAN $0 $0 $0
WellSense Clarity NH Silver 5000 Core 1 $0 $37.50 $125
WellSense Clarity NH Silver 5000 Core 2 $25 $50 $150 after deductible
WellSense Clarity NH Silver 5000 Core 3 $50 $100 $200 after deductible
WellSense Clarity NH Silver 5800  $50 $100 $200 after deductible
WellSense Clarity NH Silver 5800 AIAN $0 $0 $0
WellSense Clarity NH Silver 5800 Core 1 $50 $75 $200
WellSense Clarity NH Silver 5800 Core 2 $50 $75 $200 after deductible
WellSense Clarity NH Silver 5800 Core 3 $50 $100 $200 after deductible
WellSense Clarity NH Gold 1500 $37.50 $75 $150
WellSense Clarity NH Gold 1500 AIAN $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 .

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