The eligibility and enrollment rules for the U

Retiree Health Care SPD Effective January 1, 2012
drugs. If you are currently eligible for Medicare Part B coverage, the Program will coordinate
with Medicare Part B. If you wish to submit prescriptions for Medicare Part B-eligible drugs to
Medicare, you will need to go to a Retail Pharmacy that is a “Medicare supplier” and present
your Medicare card. The Retail Pharmacy will need to submit these claims to Medicare on your
behalf as noted below:
• At Retail: When using a Retail Pharmacy, you will be asked to present your Medicare ID
card. The Retail Pharmacy will work with you to bill Medicare on your behalf. The Retail
Pharmacy will also submit any other claims that may be eligible for additional coverage.
Most independent pharmacies and national chains are Medicare suppliers.
• At Mail: Medco Pharmacy (Medco’s mail order service) is not a Medicare supplier;
therefore if you submit your prescription to Medco Pharmacy, the Program will not
coordinate your benefit with Medicare.
Cost of your medication: You will be required to pay your copayment/coinsurance as
determined by your pharmacy option. If you go to a “Medicare supplier” and Medicare pays your
claim, you could also be reimbursed for additional costs not paid by Medicare. To determine if
your option will pay any additional costs not paid by Medicare, ask your pharmacist to
electronically submit the additional costs to Medco for processing under your U.S. Bank
Program option. If using a Retail Pharmacy you must use a Medco participating Retail Pharmacy
that will submit your secondary claim electronically to determine if you are eligible for
additional benefits. Paper claims sent to Medco will not be eligible for any additional
reimbursement.
If it is determined that the medication or product is not eligible for coverage under Medicare Part
B, normal provisions associated with your option will apply. Refer to the “Mail Order
Maintenance Drug Provision” section and the “Specialty Drug Provision” section in this SPD for
more information.
Any prescription excluded from coverage is also excluded under the Medicare Part B Program.
This program is subject to change. If you have any questions, please contact Medco at 1-800-
864-1404.
Health Management Program
Health Management Program participants generally receive educational mailings and toll-free
phone access to registered pharmacists. In some programs, participants may also receive followup
calls from Medco’s pharmacists. Medco develops these voluntary programs to support your
doctor's care and may contact your doctor regarding your eligibility for, or participation in, these
programs.
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