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Prescription Drug coverage Part of the Medical Plan 11.

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Presentation on theme: "Prescription Drug coverage Part of the Medical Plan 11."— Presentation transcript:

1 Prescription Drug coverage Part of the Medical Plan 11

2 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 2

3 Purchase your Rx drugs here Pharmacy located at CMMC NOTE: 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. 3

4 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: 4

5 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 5

6 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 6

7 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 7

8 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 8

9 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

10 What are the co-pays? 30 Day supply @ CMH Pharmacy OTC Generic PreferredNon-preferred In-house$ 4 $ 4 $15 $35 Outside$10 $10 $30 $50 10

11 What are the co-pays? 60 Day supply @ CMH Pharmacy OTC Generic PreferredNon-preferred In-house$ 8 $ 8 $30 $70 Outside$20 $20 $60 $100 11

12 What are the co-pays? 90 Day supply @ CMH Pharmacy OTC Generic PreferredNon-preferred In-house$10 $10 $45 $95 Outside$30 $30 $90 $150 12

13 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: 1. Benny Card 2. Cash 3. Credit card payment 13

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