|
|
|
NEW
PRESCRIPTION DRUG BENEFIT Retail Pharmacy
Program: Retail pharmacy benefits are provided through a retail
pharmacy network. The network
includes 62,000 participating pharmacies throughout the When you have your prescription filled at a participating
pharmacy, you no longer have to file a claim form to be reimbursed for
prescription drug expenses. The Plan
will automatically pay 20% of the
cost of the medication, after you have met the retail pharmacy annual deductible
amount of $75.00 per person/$200 per
family. If you do not have your prescription filled at a
participating pharmacy, you will have to pay the full cost of the prescription
when you have it filled and then submit a completed Caremark claim form for reimbursement. (Very few pharmacies are not
in the network. If you should happen
to need a paper claim form, please contact the Fund Office.) The new retail pharmacy benefit program got off to a rocky
start Every eligible
participant should have received a new CVS/Caremark prescription benefit ID
card. It is imperative that you use
this card when acquiring prescriptions at a retail pharmacy.
Please note that the new card has a new “RXGRP” number.
The new number is prefaced with REX2 instead of T108.
Please make sure the
card you use has REX2 as the Group Number! If anyone is continuing to have a problem or needs additional
help, please do not hesitate to contact the Fund Office at: 317-549-6005 or
1-800-762-1215 and we will be glad to assist you. The new retail prescription drug program is a very valuable
benefit for those of you who need a short term prescription; however, the
mail-order program is still the best benefit for maintenance medications. Mail-Order Program: Use
the mail-order prescription drug program when you need to fill a prescription
for maintenance drugs (medications that you take for three months or more).
The program is especially convenient for filling prescriptions for
arthritis, high blood pressure, heart conditions, or diabetes. To ensure high quality care and to help manage costs, the
Plan’s mail-order prescription drug program has a list of preferred
medications, known as a formulary. The
formulary consists of prescription medications that are either more effective
than others in their class or as effective and less costly than similar
medications. Non-formulary brand
name medications include those that are not on the formulary but that have a
therapeutic alternative that is in the formulary.
(A list of the formulary drugs, “Performance Drug List” is printed in
this newsletter.) You can save money by using the mail-order prescription drug
program. Here is how it works.
When you order by mail, you can get a larger quantity of medication at
one time—up to a 90-day supply. The
Plan pays 100% of the costs after you pay the applicable copayment.
Copayments are as follows:
Formulary Brand Name Medication
$35
for a 90-day supply
Non-Formulary Brand Name
$70 for a 90-day supply |