How your pharmacy benefits work 1 2 3 4 5 Show your ID card at the counter Give the pharmacist your medical (and/or pharmacy) ID card when you pick up your prescription. Your prescription is priced The pharmacy runs your prescription through your insurance and tells you what you owe at the counter. Payment counts towards deductible The amount you pay for covered prescriptions applies toward your plan deductible total. Deductible met? Met the deductible? You may be responsible for a copay or coinsurance and then your plan pays the rest. OOP met? You pay nothing Once you hit your out - of - pocket maximum, the plan pays 100% of covered prescriptions for the rest of the plan year.