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Prescription Drug Benefits

The prescription drug benefit is another provision of your health & welfare coverage.  It is designed to cover medications prescribed by your health care provider and dispensed at a pharmacy.  Through Caremark, the Plan has negotiated prices for most medications purchased from a  pharmacy that is a member of the Caremark network.  The negotiated price is usually lower than retail.

There are two ways to buy prescription drugs:

Retail Pharmacy

The Plan covers up to a 30-day supply of medication from a retail pharmacy. This benefit is designed for short-term or single use medications. 
 

Mail Order Pharmacy

The Plan covers up to a 90-day supply of medication from a mail-order pharmacy. This benefit is designed for long-term or maintenance medications.  Using Caremark via mail or internet, you may receive a 90-day supply for the price of 60-days! 

The Plan allows for you to refill your prescriptions after 2/3 of the prescribed dosage has been used.
 

Co-Payments and Maximums for Plan 500, Medical Plans 551-556, COBRA Plans 590-598, and all Retiree Plans

Your co-payment amounts are as follows:

Your annual out-of-pocket limit for prescription drugs is $750 per person or $1500 per family.  Should you select a brand name medication when a generic is available, your prescription will not be covered by the Plan. If you do not use your ID card, or use a non-member pharmacy, the difference between the retail charge and the contracted rate will not apply to your out-of–pocket maximum.
 

Co-Payments and Maximums for Plan 520

The Plan will pay 20% of the cost of your prescription, whether it is brand name or generic. The remaining cost of the prescription (80%) will be your co-payment.  If you do not use your ID card, or use a non-member pharmacy, the difference between the retail charge and the contracted rate will not apply to your out-of–pocket maximum.

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