Page 6 - Acadia 2022 Benefits Guide | Tower
P. 6
Discover My Acadia Health
Health Care Coverage
Prescription Drug Plan
Step Therapy Program Maintenance Matters Program
Do you know that the Food and Drug Administration (FDA) The Maintenance Matters program from BCBST helps you
get the medications you need while saving you time and
requires generic drugs to have the same strength and purity as money. If you’re taking a maintenance medication to treat
brand-name drugs? Generic drugs can be just as effective as a chronic condition, such as high blood pressure, diabetes,
their brand-name counterparts at a fraction of the price, so why etc., you must now get them illed in a 90-day supply via
would you spend more than you have to on your prescription home delivery or retail pharmacy in the Plus90 network.
medications? Choose generics and save!
If you choose not to participate in the program, you will be
Before you use one of the brand-name drugs, you will irst need allowed two 30-day reills of your maintenance medication
to try a similar, alternative medication. For Example: Before you then will have to pay the entire cost of future 30-day reills.
can ill a new prescription for the brand name drug Cymbalta, To get started, have your retail pharmacy contact your
you will need to try one of the generic alternatives irst: doctor to request a 90-day supply. For more information
bupropion, luoxetine, paroxetine, sertraline, or venlafaxine. Visit on this new program, call the number on the back of your
www.bcbst.com for up-to-date information.
BCBST identiication card.
Mail Order Pharmacy—It’s Easy!
Looking for a convenient way to purchase the prescription
medications you take on a regular basis? Have them delivered
to your home with Home Delivery from CVS. With Home
Delivery, you can buy up to a 3-month supply of medications
you take regularly and pay the cost of a 2-month supply. And Here’s an example of how Maintenance Matters can save
you can order reills anytime online or by phone. Call the you money! A member is enrolled in the Acadia medical
number on the back of your BCBST identiication card or visit plan and typically gets his or her generic prescription
www.bcbst.com for more information. illed at a local, retail pharmacy. He or she pays a $10 copay
for a 30-day supply. Now he or she gets the exact same
prescription conveniently delivered to his or her doorstep
Prescription Mail Order Program in a 90-day supply for just a $20 copay.
CVS Replaces Express Scripts
Effective 1/1/2022, CVS will be the company that manages
pharmacy beneits for BCBST. While most of your
pharmacy beneits will remain the same, there are a few
items that will be changing this plan year:
y New BCBST ID cards will be mailed in December 2021.
y If you use Express Scripts mail order, your prescriptions
will automatically be transferred to CVS mail order. You
will need to set up a new account with CVS and input
your credit card information. A letter will be mailed to
you in November with directions on setting up your
new account.
y BCBST uses CVS’s pharmacy network, which has more
in-network pharmacies compared to Express Scripts.
If you are illing at a pharmacy, which will no longer be
considered in-network, a letter will be mailed to you
notifying you of the change.
6 | Tower Behavioral Health
Health Care Coverage
Prescription Drug Plan
Step Therapy Program Maintenance Matters Program
Do you know that the Food and Drug Administration (FDA) The Maintenance Matters program from BCBST helps you
get the medications you need while saving you time and
requires generic drugs to have the same strength and purity as money. If you’re taking a maintenance medication to treat
brand-name drugs? Generic drugs can be just as effective as a chronic condition, such as high blood pressure, diabetes,
their brand-name counterparts at a fraction of the price, so why etc., you must now get them illed in a 90-day supply via
would you spend more than you have to on your prescription home delivery or retail pharmacy in the Plus90 network.
medications? Choose generics and save!
If you choose not to participate in the program, you will be
Before you use one of the brand-name drugs, you will irst need allowed two 30-day reills of your maintenance medication
to try a similar, alternative medication. For Example: Before you then will have to pay the entire cost of future 30-day reills.
can ill a new prescription for the brand name drug Cymbalta, To get started, have your retail pharmacy contact your
you will need to try one of the generic alternatives irst: doctor to request a 90-day supply. For more information
bupropion, luoxetine, paroxetine, sertraline, or venlafaxine. Visit on this new program, call the number on the back of your
www.bcbst.com for up-to-date information.
BCBST identiication card.
Mail Order Pharmacy—It’s Easy!
Looking for a convenient way to purchase the prescription
medications you take on a regular basis? Have them delivered
to your home with Home Delivery from CVS. With Home
Delivery, you can buy up to a 3-month supply of medications
you take regularly and pay the cost of a 2-month supply. And Here’s an example of how Maintenance Matters can save
you can order reills anytime online or by phone. Call the you money! A member is enrolled in the Acadia medical
number on the back of your BCBST identiication card or visit plan and typically gets his or her generic prescription
www.bcbst.com for more information. illed at a local, retail pharmacy. He or she pays a $10 copay
for a 30-day supply. Now he or she gets the exact same
prescription conveniently delivered to his or her doorstep
Prescription Mail Order Program in a 90-day supply for just a $20 copay.
CVS Replaces Express Scripts
Effective 1/1/2022, CVS will be the company that manages
pharmacy beneits for BCBST. While most of your
pharmacy beneits will remain the same, there are a few
items that will be changing this plan year:
y New BCBST ID cards will be mailed in December 2021.
y If you use Express Scripts mail order, your prescriptions
will automatically be transferred to CVS mail order. You
will need to set up a new account with CVS and input
your credit card information. A letter will be mailed to
you in November with directions on setting up your
new account.
y BCBST uses CVS’s pharmacy network, which has more
in-network pharmacies compared to Express Scripts.
If you are illing at a pharmacy, which will no longer be
considered in-network, a letter will be mailed to you
notifying you of the change.
6 | Tower Behavioral Health
