Pharmacy Benefits
GatorCare members are required to satisfy a prescription drug deductible for purchases of all Tier 2-5 prescription drugs before the plan’s prescription benefits apply. The deductible amount is $125 per covered person, with a deductible cap of $500 per family. Each member will pay the deductible plus any applicable coinsurance, up to the cost of the drug. For drugs that cost less than $125, members will pay the cost of the drug, until the $125 prescription drug deductible is met. The deductible applies regardless of whether you purchase your prescription from a retail or mail order pharmacy. Representatives at the Liviniti Call Center have access to the GatorCare formulary and can help review coverage. They can be reached at 833-946-3811. * The pharmacy deductible does not apply to HDHP Saver plans.
GatorCare plans require a mandatory 90-day supply at retail or mail delivery for certain maintenance medications, following three 30-day grace fills. Some maintenance medications are excluded from the mandatory 90-day supply.
Specialty and certain brand medications must be filled at one of the UF Health pharmacies.
Prescriptions, up to 34-day retail supply:
| Tier 0: Value Based | 0% coinsurance -includes Healthcare Reform medications covered at no cost to member (no Rx CYD applies) |
| Tier 1: Generic | 25% coinsurance with $10 minimum to $20 maximum (no Rx CYD applies) |
| Tier 2: Preferred Brands | 25% coinsurance with $25 minimum to $50 maximum after Rx CYD * |
| Tier 3: Preferred Specialty | 25% coinsurance with $50 minimum to $100 maximum after Rx CYD * |
| Tier 4: Non-Preferred Brands | 40% coinsurance with $70 minimum to $240 maximum after Rx CYD * |
| Tier 5: Non-Preferred Specialty | 40% coinsurance with $70 minimum to $240 maximum after Rx CYD * |
Prescriptions, 90-day supply retail and mail order:
| Tier 0: Value Based | 0% coinsurance -includes Healthcare Reform medications covered at no cost to member (no Rx CYD applies) |
| Tier 1: Generic | 25% coinsurance with $25 minimum to $50 maximum (no Rx CYD) |
| Tier 2: Preferred Brands | 25% coinsurance with $62.50 minimum to $125 maximum after Rx CYD * |
| Tier 3: Preferred Specialty | N/A |
| Tier 4: Non-Preferred Brands | 40% coinsurance with $175 minimum to $600 maximum after Rx CYD * |
| Tier 5: Non-Preferred Specialty | N/A |
How do I learn which tier my prescription falls under?
Navigate to Liviniti’s Company Page Lookup and enter your group number or “GatorCare” in the search field. Once the GatorCare company page opens, enter your medication in the medication search tool.
All matches for the medication will appear under Medication Name, including the tier at which the medication is offered through the GatorCare formulary. Checking your medication’s formulary tier can help you understand your coverage and may help reduce your out-of-pocket costs.
For more information and assistance, members may contact the GatorCare dedicated line at Liviniti at 833-946-3811.
Pharmacy Network
Liviniti network includes more than 60,000 retail pharmacies. All major chains are included (UF Health Pharmacies in Gainesville, Jacksonville, and Leesburg, UF Student Health Care Center, Walgreens, CVS, Publix, Winn-Dixie, Target, Kroger, etc.). To learn more or verify if a pharmacy is in-network, visit the Liviniti Member Center or call customer service at 833-946-3811.
Reach out to your UF Health pharmacy to see if they offer delivery to your location.
In certain cases of specialty medications, restrictions may require they be filled through the UF Health Pharmacy. Prior to having a specialty medication filled, members should contact Liviniti at 833-946-3811.
All members are encouraged to use the UF Health Pharmacies, as they are in-network and offer member discounts.