CHURCHWIDE HEALTHCARE - Pension Fund
CHURCHWIDE HEALTHCARE - Pension Fund
CHURCHWIDE HEALTHCARE - Pension Fund
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Prescription Drug Program Overview<br />
Prescription Drug Program<br />
The CCHCBT, through its partnership with Medco, a<br />
Pharmaceutical Benefit Manager, has a tiered prescription<br />
drug program. That means that you pay the lowest<br />
co-payments when you use tier 1 (generic) drugs.<br />
Below is the co-payment structure at retail pharmacies<br />
for a 30-day supply:<br />
Annual Deductible: $50 Individual; $100 Family<br />
Tier 1 (Generic): $10<br />
Tier 2 (Brand Formulary): 20%<br />
(min. $25-max. $75)<br />
Tier 3 (Brand Non-Formulary): 50%<br />
(min. $4O-max. $120)<br />
When you go to in-network pharmacies, you will be<br />
responsible for paying the copay or coinsurance - nothing<br />
more. The pharmacy will bill Medco for the left-over<br />
amount. As you can see, you will pay the lowest copay<br />
if you use a generic drug. Make sure to ask your pharmacist<br />
if a generic alternative is available for the brandname<br />
drug you are prescribed.<br />
You must use pharmacies that are in Medco’s network<br />
to receive the benefit levels above. Over 90% of pharmacies<br />
nationwide currently belong to this network.<br />
Should you use an out-of-network pharmacy, you will<br />
be responsible for the co-pay listed above plus 20% of<br />
the remaining cost of the drug.<br />
The plan provides for 3 refills of medication at a retail<br />
pharmacy. After this, the plan will require you to pay an<br />
additional cost, unless you have this medication filled<br />
using Medco Mail Pharmacy.<br />
Wouldn’t you rather pay $4 for<br />
your prescription?<br />
Did you know that Wal-Mart offers over 300 different<br />
drugs at only $4 per prescription fill or refill (up to a<br />
30-day supply or 60 pill maximum). The program is<br />
available at all Wal-Mart, Sam’s Club and Neighborhood<br />
Market pharmacies. A similar program is also offered<br />
through Target stores.<br />
Brand Formulary-Name Drugs<br />
What is a brand-name drug?<br />
A brand-name druge is a prescription drug that is marketed<br />
under a proprietary, trademark-protected name.<br />
What is a Tier 2 Drug?<br />
A Tier 2 Drug is a “preferred” brand-name drug. The<br />
list of these preferred drugs is created by Medco, your<br />
pharmacy vendor. Many factors are taken into account<br />
when deriving the list, such as the utilization of the<br />
drugs, the cost, and the therapeutic class to name a few.<br />
What is important to know is that Tier 2 Prescription<br />
Drugs are less expensive than Tier 3 Prescription Drugs.<br />
Tier 3 are non-preferred and have the highest coinsurance<br />
level attached to them.<br />
Where can I find the Formulary Drug List?<br />
The Formulary Drug list is updated quarterly to ensure<br />
that newer, more effective drugs are on it. Drugs automatically<br />
come off the list when generic alternatives<br />
become available. To get the most updated formulary<br />
list, register at www.medco.com. Once there, you can<br />
download the formulary listing or search for a medication<br />
by name.<br />
You may want to print off the formulary list and take<br />
it with you to your next doctor’s appointment. If your<br />
doctor has the list, he or she can be sure to prescribe<br />
you a preferred drug. Make sure you take the most<br />
updated list as it is updated quarterly.<br />
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