New Copays Begin July 1, 2026 (Active and Pre-Retiree Members) and January 1, 2027 (Retirees)
The following prescription drug and medical copayment changes apply to both the active and retiree plans and will be effective July 1, 2026, for active members and January 1, 2027, for retiree members. This is the first time over the past ten years that SWSCHP has modified these copayments:
Generic prescription drug copayment: Increase from $7.50 to $10.00
Specialty prescription drug copayment: Increase from $16.75 to $30.00
Primary Care Physician, Specialist: Urgent Care copayment: Increase from $25.00 to $30.00
Inpatient hospital copayment: Increase from $200.00 to $250.00
Emergency Room copayment: Increase from $75.00 to $100.00
Thank you for your review of these changes. Please contact your care coordinators at Quantum (www.swschpcarecoordinators.com) if you have any questions.