The eligibility and enrollment rules for the U

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Retiree Health Care SPD Effective January 1, 2012 • Refills by phone – Call 1-800-864-1404. Have your member ID number from your Medco ID card, your refill slip with the prescription number, and your credit card ready. • Refills by mail – Use the refill and order forms provided with your medication. Mail them with your copayment/coinsurance to: Medco P.O. Box 650322 Dallas, TX 75265-0322 Paying for Your Medication You may pay by check, eCheck, money order, VISA, MasterCard, Discover/NOVUS, American Express, Diner’s Club or debit card. Call Medco at 1-800-864-1404 or TTY/TDD (for the hearing impaired) at 1-800-759-1089. If your account balance is over $150 and you do not have a credit or debit card on file, Medco will contact you for payment arrangements. If your account balance is over $500 and you do have a credit or debit card on file, Medco will contact you for authorization to bill the credit or debit card. Authorization of Payment. When an order is received at the pharmacy and is in the input area, the credit card will be authorized for the cost of the order. The actual charge to the credit card occurs when the order is shipped. Order requested through the mail. When an order is requested through the mail, the system will charge the credit card that is noted as the preferred card. If you include updated billing information with the order, the input technician will update the system. Order placed through the IVR. When you request a refill through the phone system, you are given the option of charging the preferred card or selecting a different card for one-time use. You also have the option of changing or adding a card to your billing information. Order placed through the Web. You have the option of adding or updating credit card information through the Web site, including the enrollment or cancellation of your participation in the Auto Charge Program at any time. Order placed by phone. You may request a one-time charge to your credit card or you may choose to enroll in Medco’s Auto Charge Program. The Auto Charge Program enables Medco to keep a credit card on file to charge automatically without you having to call and provide authorization each time. You may enroll or request cancellation of your participation in the Auto Charge Program at any time by calling Medco at 1-800-864-1404. Unpaid member accounts: U.S. Bank is committed to paying all eligible prescription drug claims incurred under the terms of the Program with Medco chosen as the pharmacy Claims Administrator. If a Medco member account is not paid timely, U.S. Bank will be notified. Past due account balance billings will be first sent by Medco. If after several attempts to collect, the member account remains unpaid, U.S. Bank will be required to satisfy the balance. Should U.S. Bank pay an account balance on behalf of an enrolled member, the delinquent account holder will be notified, at that time, and U.S. Bank will advise of their right to collection. Such account holders (including covered family members) will also lose their right or privilege of future 72
Retiree Health Care SPD Effective January 1, 2012 billings and will be required to “pay as you go”. All account inquiries should be directed to Medco by calling 1-800-864-1404. Also see the “Recovery of Excess Payments and Correction of Errors” section in this SPD for more information. Delivery of Your Medication Your address within the Shipping Information on your profile is populated and updated by U.S. Bank’s enrollment and eligibility process. Prescription orders may also be sent using the address provided by you under the Shipping Information section of the Medco by Mail Order Form. If you need to verify or update this address, call Medco at 1-800-864-1404 or access your profile online at www.medco.com. Prescription refill orders are usually sent to you by U.S. mail in about a week. (Please allow 14 to 21 days turnaround time for an initial order.) Overnight delivery is available for an additional charge. Your enclosed medication will include instructions for refills, if applicable. Your package may also include information about the purpose of the medication, correct dosages and other important details. Note: • The pharmacist's judgment and dispensing restrictions, such as quantities allowable, govern certain controlled substances and other prescribed drugs. Medco prohibits the return of all dispensed drugs. • Prescription orders will not be filled more than 12 months after issuance, more than six months after issuance for controlled drug substances or if prohibited by applicable law or regulation. Due to certain situations, Medco may need to split your order to avoid delaying receipt of your medications. Some of these situations might include: • When there are multiple prescriptions written on the same prescription slip and additional information from the doctor or member is needed; • When a member sends in multiple prescription requests on separate forms but one medication may be for a controlled substance that might need to be dispensed from a different location due to state mandates or regulations; • A specific medication may be on backorder; or • One of the medications may be subject to additional review. Members are notified of split orders on the statement that is sent by the Medco Pharmacy with their mail order. Split orders may impact the refill dates. It is always important to check the refill/renewal dates on each prescription. How to Place a Successful Mail Service Order 1. For new prescriptions: Medco recommends that your physician write out two prescriptions: • A short-term script (up to 31 days) that can be filled at a Retail Pharmacy. This gives you up to 31 days of medication while completing and mailing the order forms and waiting for the initial shipment. • A long-term prescription written for a 90-day supply with three refills. Mail this prescription along with the Medco by Mail Order Form to the Medco Pharmacy (Medco’s mail order service). This prescription will usually offer a full year supply before a new prescription must be obtained. 73
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