All CDHP Plans IN NETWORK OUT-OF-NETWORK Retail Prescriptions: 0% after Deductible 40% after Deductible Generic Retail Prescriptions: 40% after Deductible 40% after Deductible Preferred Retail Prescriptions: 50% after Deductible 40% after Deductible Non-Preferred Mail Order Prescriptions: 0% after Deductible Not Covered Generic Mail Order Prescriptions: 40% after Deductible Not Covered Preferred Mail Order Prescriptions: 50% after Deductible Not Covered Non-Preferred
DePauw University 2025 Benefit Guide Page 13 Page 15