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Prescription Drug Plan

Emory Medical House Staff prescription drug benefits.

Tier Zero for 2009

Tier Zero is the prescription drug tier for generic prescription drugs that treat congestive heart failure, diabetes, high blood pressure and high cholesterol. The co-pay for Tier Zero prescription drugs will be waived. That’s right, Emory pays 100% and plan participants will pay $0 for a 30- or 90-day prescription supply.

Some drugs that are included in Tier Zero are:

  • Hydrochlorothiazide
  • Furosemide
  • Glyburide
  • Simvastatin

Here is a complete list of all Tier Zero drugs.

Generic Drugs — A Great Value

Using generic drugs is a great way to lower your prescription drug costs. If your physician prescribes a brand-name drug and does not specify to “Dispense as Written” (“DAW”), ask your pharmacist if a generic version is available. If your physician does check the “DAW” box, the pharmacist is required to dispense the brand-name drug. However, it is important to know that you will pay the higher brand-name drug co-pay/co-insurance, as well as the difference in cost between the generic and brand-name drug.

 

Save Money and Time — Get Your Prescriptions in the Mail

If you take prescription medication on an ongoing basis, there are specific advantages associated with using mail order:

•   Cost savings — By receiving a 90-day supply, you won’t have to go to the pharmacy and you’ll incur fewer co-pays.

•   Free shipping — No extra charge for shipping when you receive your prescriptions through the mail.

•   Convenience — You don’t have to leave your home, stand in lines or wait at a drugstore for
your medication.

Here’s an example of your savings using mail order for a Tier One prescription:

In-Network Retail Pharmacy

Mail Order Pharmacy Service

Month One

$12 co-pay for first 30-day prescription

$30 co-pay for a 90-day supply

Month Two

$12 co-pay for first refill

n/a

Month Three

$12 co-pay for second refill

n/a

Total

$36 for a 90-day supply

$30 for a 90-day supply

Your Savings = $6 (per 90-day supply) or $24 for the year

For Aetna POS and BCBS-GA PPO members, more information on Medco mail order prescriptions can be found at www.medco.com or by calling 800-939-3758.

(Please be aware Tier Zero will appear as Tier 5)

How to Fill Your Prescription

Use your Medco Pharmacy Card at a participating pharmacy when you have a prescription filled.

To begin using the Mail-In Prescription service:

  • Step 1: Call Medco Prescription Service at (800) 473-3455. Customer Service will assist you in getting your prescription to Medco by mail or fax.
  • Step 2: Mail your written prescription with the Medco Prescription Mail Order Form or have your doctor fax in your prescription with the Medco Prescription Fax Form. Make sure your information is on the forms.

Note: Refer to Benefits Terminology for an explanation of terms, if necessary.

Vendor Contacts

Medco
(800) 939-3758

How the Plan Works

Emory's prescription drug benefits for the Aetna POS and BCBS-GA PPO Plans are provided by Medco and enable you and your covered dependents to have prescriptions filled at a participating pharmacy or to use the mail service program.

Prescription drugs are divided into five tiers which affect the cost of the drug. Having the prescription filled at a retail pharmacy versus using the mail service also affects the cost.

* Your plan documentation provides you with a booklet listing the most common drugs and their tier level. Your physician and pharmacist can also provide information on the tier level for specific drugs.

** Mail Order - Maintenance medications (taken daily) should be issued by your physician and remitted to Medco as a 90 day supply, refillable 3 times.

You can take advantage of Medco's mail order program to obtain up to a three-month supply of maintenance drugs for the cost of two retail co-pays. You should request two prescriptions from your doctor; the first, for a 30-day supply to fill immediately at a participating pharmacy and second, for a 90-day supply to be filled through the mail.

Note:

  • If the cost of the drug is less than the co-pay, you pay the cost of the drug.
  • At retail, when a generic drug is available, but the brand name is dispensed for any reason, you pay the brand co-pay plus the difference between the brand-name drug and the generic drug.

Plan Information Documents

Medco Pocket Formulary Guide Tier Zero
   

Plan Forms

Medco Prescription Mail Order Form Medco Prescription Fax Form
Medco Prescription Claim Form

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(404) 727-7613

Disclaimer

Emory reserves the right to terminate, suspend, withdraw, amend or modify the Plan in whole or in part at any time. Further, Emory reserves the right to terminate or modify coverage for any group of employees, active or retired and their dependents or a class of dependents at any time.