The calculation below is based on a typical single payor plan.

The calculation does not include coordination of benefits (if any) with a secondary plan. Since private plans vary significantly and if you have a secondary payor you may pay less out of pocket up front then this calculator assumes and hence the amount reimbursed by this program would reflect that. Any outstanding amount that is not reimbursed by your benefit plan(s) can be submitted to the ChoixOriginal program and you will be reimbursed for a portion of what you paid for your covered medication.