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Health & Welfare
Prescription
Drugs
Prescription Drugs -
Frequently Asked Questions
Yes, effective January 1, 2003, all retirees are required to use the prescription drug plan in order to
take advantage of lower negotiated rates at the Caremark network of
pharmacies. Click here to
learn how to save money by using Caremark.
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Mail order is a
cost-effective way to obtain medications you take on an on-going
basis. Mail order prescriptions are filled in 90 day increments
(even if the script is for a year). To fill a new prescription,
you must submit a
Mail Order Form and provide
an original doctor’s script which indicates whether a brand name drug
or a generic is appropriate.
When you need a refill, simply call
Caremark at 1-866-818-6911 or log on to their website reorder. Your prescription will be
sent to you via the US Postal Service or through a delivery service if
special handling is required.
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Yes, when you are
covered by more that one health plan, submit claims to the primary
payor first. The Alaska Electrical Health & Welfare Plan is usually
primary on the employee and secondary on the spouse. The
“birthday rule” generally determines which plan is primary on covered children.
The plan of the parent whose birthday falls earlier in the year is the
primary payor.
If the other
health plan is primary, use the other plan’s prescription drug card
and/or submit the claim to the other plan first. Once the primary plan
makes its payment, you may file a secondary claim with the
Administrative Office to
access secondary coverage under the Alaska Electrical Health & Welfare Fund.
When the Alaska
Electrical Health & Welfare Plan is secondary, the Plan will pay 100%
of the portion of the claim that is not paid by the primary plan.
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The Plan allows for you to refill your
prescription refill after 2/3 of the prescribed dosage has been used.
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When the Caremark system rejects a
prescription, the reason for the denial is transmitted to the
pharmacist. The pharmacist may call the Caremark Pharmacist Hotline
at 1-877-478-1246, option 4, to resolve the problem. If the problem cannot be
resolved by the pharmacist, please contact the Administrative Office for
assistance.
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Why is my co-payment so much more for a brand name drug than a generic
drug?
Co-payments for brand name drugs are higher
than co-payments for generic drugs primarily because brand name drugs
cost so much more than generic drugs.
Once a drug patent has expired, other companies
may start to sell the same drug under another name. The generic
drugs are not normally advertised, helping to keep their costs to a
minimum. Generic drugs are
required by the federal Food & Drug Administration to have the same
quality, strength, purity, and stability as brand name drugs.
By using generic drugs when they are available, participants can
receive the same quality of health care for less money - and these
savings can be used to help offset other health care expenses.
For these reasons, the Trustees have set the co-payment for generic
drugs much lower. The Plan will not cover brand name when
generic is available.
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