Retail Prescriptions (34-Day Supply): Generic $8 $8 $8 Retail Prescriptions: Preferred 30% or $40 (greater of)* 30% or $40 (greater of)* 30% or $40 (greater of)* Retail Prescriptions: Non-Preferred 50% for $60 (greater of)* 50% for $60 (greater of)* 50% for $60 (greater of)* Mail Order Prescriptions (90- Day Supply): Generic $12 $12 $12 Mail Order Prescriptions: Preferred 30% or $80 (greater of)* 30% or $80 (greater of)* 30% or $80 (greater of)* Mail Order Prescriptions: Non-Preferred 50% or 120 (greater of)* 50% or 120 (greater of)* 50% or 120 (greater of)* PPO PLAN HDHP PLAN ONE HDHP PLAN TWO * If brand name drug purchased when generic drug available and approved by physician, covered person will be responsible for the applicable brand copayment plus the difference in the cost of the generic and the brand name drug purchased.