prescription drug coverage

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Prescription Drug coverage Part of the Medical Plan 1

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Prescription Drug coverage. Part of the Medical Plan. Special rules for Maintenance Drugs. A Maintenance Drug is an ongoing drug that is refilled month after month. Common examples are high blood pressure medication, cholesterol drugs and birth control pills - PowerPoint PPT Presentation

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Page 1: Prescription Drug coverage

Prescription Drug coverage

Part of the Medical Plan

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Page 2: Prescription Drug coverage

Special rules for Maintenance Drugs

A Maintenance Drug is an ongoing drug that is refilled month after month. Common examples are high blood pressure medication, cholesterol drugs and birth control pills

Due to the costing and predictability of Maintenance Drugs, all such refills MUST be obtained through the CMH Pharmacy

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Page 3: Prescription Drug coverage

Purchase your Rx drugs here

Pharmacy located at CMMCNOTE: Non-maintenance drugs and the initial 30

day maintenance drug fill may be purchased at a retail pharmacy

• Hannaford• Rite Aid• CVS• Wal*Mart, etc.

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Page 4: Prescription Drug coverage

Where is the Pharmacy located?

1. Southern end of the hallway on the second floor of CMMC

2. Open from 7:00 a.m. to 5:00 p.m.

3. Monday through Friday

4. Phone: 795-7177

5. Fax: 795-7552

6. E-mail: [email protected]

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Page 5: Prescription Drug coverage

How do I order my Rx?If you use a CMMF doctor, your Rx can

be submitted electronically

You may also do the following:1. Present your Rx to the Pharmacy in person

2. Ask your doctor to call the Rx in (795-7177)

3. Ask the pharmacy to call your provider

4. Email the pharmacy [email protected]

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Page 6: Prescription Drug coverage

Why should I use the CMMF Pharmacy instead of

another?1. You will save money on your co-pays (EVERY co-pay

is less expensive when using our Pharmacy)

2. The CMH Medical Plan will save money - the premiums established by our medical plan reflect nearly $600,000 in savings due to employees using the in-house pharmacy

3. We are a 340B Pharmacy which, under federal guidelines, our purchase rates are typically lower than retail pharmacies

4. Maintenance Drug refills are required to be purchased through the CMH Pharmacy

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Page 7: Prescription Drug coverage

What are the level of drugs?Drugs fall into four categories:1. Certain over-the-counter drugs (i.e.

prilosec)

2. Generic drugs

3. Preferred Brand name drugs

4. Non-preferred Brand name drugs

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Page 8: Prescription Drug coverage

May I purchase a 90 day supply?

1. You may purchase your Rx in various increments. Your doctor may prescribe dosages of any number of days (typically a 30 day, 60 day or 90 supply)

2. For “maintenance drugs”, those taken continuously and for long periods of time, purchasing in 90 day increments seems the most practical

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Page 9: Prescription Drug coverage

Conveniences of using the CMH Pharmacy

There are a number of reasons to use the in-house pharmacy rather than retail:

1. ALWAYS lower co-pays

2. Free mail-order to your home

3. Ease of calling or emailing in the prescription

4. The plan saves cost contributing to affordable plan premiums

Page 10: Prescription Drug coverage

What are the co-pays?

30 Day supply @ CMH Pharmacy

OTC Generic Preferred Non-preferred

In-house $ 4 $ 4 $15 $35

Outside $10 $10 $30 $50

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Page 11: Prescription Drug coverage

What are the co-pays?

60 Day supply @ CMH Pharmacy

OTC Generic Preferred Non-preferred

In-house $ 8 $ 8 $30 $70

Outside $20 $20 $60 $100

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Page 12: Prescription Drug coverage

What are the co-pays?

90 Day supply @ CMH Pharmacy

OTC Generic Preferred Non-preferred

In-house $10 $10 $45 $95

Outside $30 $30 $90 $150

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Page 13: Prescription Drug coverage

How do I pay for my Rx?In-house pharmacy:1. Sign for payroll deduction

2. Use your Benny Card

3. Credit card payment

Outside pharmacy:4. Benny Card

5. Cash

6. Credit card payment

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