This is from the District:

We have recently received questions regarding increases in prescription medication costs. We understand that unexpected changes in out‑of‑pocket expenses can be frustrating, and we appreciate the Locals for bringing forward their members’ concerns.

Under the previous negotiated prescription plan, employees paid a fixed copay for prescription drugs. A copay is a set dollar amount paid each time a prescription is filled, regardless of the drug’s actual cost. Copay amounts depended on the drug category (generic, preferred brand, or non‑preferred brand) and whether the prescription was filled at retail or through mail order, with the insurance plan covering the remainder.
 
Beginning in 2026, the plan transitioned to a coinsurance‑based structure. Coinsurance means you pay a percentage of the drug’s cost rather than a fixed amount.

Preventive Medications

Preventive drugs are not subject to the deductible, meaning the plan begins paying immediately, and the member owes only the applicable coinsurance. This avoids the full upfront cost of the medication and can provide meaningful savings early in the plan year.
 
You do not pay the full cost first.  Insurance begins paying immediately.  You only pay your coinsurance percentage.
Non‑Preventive Medications
 
For non‑preventive prescriptions, members must meet the deductible before coinsurance applies. After the deductible is met, members pay a percentage of the drug’s cost as coinsurance. Even though coinsurance is a percentage, the plan includes maximum dollar caps for certain drug categories.

HSA Participants

For those enrolled in an HSA, funds may be used tax‑free for prescription costs, reducing out‑of‑pocket expenses and helping members reach their deductible and out‑of‑pocket maximum more quickly.

Additionally, under the new structure, the deductible and out‑of‑pocket maximum for prescription medications are integrated with Medical/Surgical, Mental Health, Substance Abuse, and CarePlus services. This means all spending on medical and prescription counts toward the same deductible and out‑of‑pocket maximum.

Information on drug classifications (generic, preferred brands, etc.) can be found in the AT&T Bargained‑for Employee Medical Program Summary Plan Description (SPD). Additional details outlining the Prescription Drug Program (Rx) and related programs are also included in the 2025 Settlement Agreement.