OAP Base $1,500 HDHP w/ HSA OAP Buy-Up $500 Preventive Prescriptions $0 $0 $0 Retail Prescriptions: Generic $10 $10* $10 Retail Prescriptions: Preferred $45 $45* $45 Retail Prescriptions: Non-Preferred $70 $70* $70 Mail Order Prescriptions: Generic $30 $30* $30 Mail Order Prescriptions: Preferred $135 $135* $135 Mail Order Prescriptions: Non-Preferred $210 $210* $210 *After deductible Prescription Coverage – In-Network