HMO/POS Prescription Benefits at a Glance: Groups 51+ AmeriHealth Forms Online — New Jersey Type Option Standard $10/$10 Standard $10/$15 Standard $10/$20 Standard $15/$15 Standard $6/$10 Standard $7/50%/$125 (HMO/POS) Standard $7/50%/$250 (HMO/POS) Standard $8/$14 Standard 50%/50% Standard HMO 50%/$125 Standard HMO Plus 50%/$125 Standard POS 50%/$125 Standard POS Plus 50%/$125 Select $10/$20/$35 Select $10/$20/$50 Select $10/$40/$60 Select $15/$25/$35 Select $15/$35/$50 Select $20/$40/$60 Select $5/$10/$25 Select $5/$10/$35 Select $5/$10/$50 Select $5/$10/50% Select $5/$15/$25 Select $5/$15/$35 Select $5/$15/$50 Select $5/$15/50% Select $5/$20/$35 Select $5/$20/$50 Select $7/$35/$50 Deductible/Coinsurance $100/$15/$15 Deductible/Coinsurance $100/$15/$25 Deductible/Coinsurance $100/$15/$25/$35 Deductible/Coinsurance $200/$15/$15 Deductible/Coinsurance $200/$15/$25 Deductible/Coinsurance $200/$15/$25/$35