The Prescription Drug Plan is offered to employees who enroll in the Research Foundation Regular Health Plan (PPO). Employees participating in a Health Maintenance Organization (HMO) are not eligible for the Prescription Drug Plan described in this document.
The Prescription Drug Plan is provided through Medco.
Prescription drug coverage is available through the following sources:
Short-term or emergency prescription drugs can be purchased from a participating or nonparticipating pharmacy. Employees present their ID card when using a participating pharmacy or complete a claim form when using a nonparticipating pharmacy. Refer to "Your Prescription Drug Benefit Handbook" for more information.
Employees have their prescriptions filled through the mail when using Medco By Mail. This source is normally used for long-term prescriptions. Refer to your "Your Prescription Drug Benefit Handbook" for more information.
The copayment schedule can be found in "Your Prescription Drug Benefit Handbook"
An employee can get up to a 90-day supply in a single prescription through the mail service but only up to a 30-day supply at a retail pharmacy.
Drugs that require a prescription under state or federal law are covered (refer also to the next section of this document "What Drugs Are Not Covered").
Generic prescription drugs are covered through retail or mail service (reimbursement may be less when using a nonparticipating pharmacy through the Medco Health Prescription Program).
Brand-name drugs are covered through retail or mail service. If a doctor prescribes a brand-name drug when a generic equivalent is available, the employee must pay the difference in cost between the generic and brand-name drug.
Medications used for treating infertility are subject to a 50 percent coinsurance for both retail and mail order prescriptions.
The following drugs are not covered under either program:
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