Page 12 - Texas Rangers 2021 Front Office Flipbook

PRESCRIPTION DRUG COVERAGE PLAN C

Program

A prescription drug program is offered as part of your health
care benefits. This program covers both non-maintenance
and maintenance prescription drugs dispensed by either
pharmacy or designated mail service Medicare Part D
The company’s prescription drug
Retail Program plan is creditable coverage. That
The retail program provides up to a 31-day supply of means it meets and exceeds
medication. Simply present your ID card at a participating Medicare Part D requirements and
pharmacy nationwide and pay the appropriate co-pay or the benefits offered by most
coinsurance amount for your medication. Medicare Part D plans. If you are
eligible for Medicare, you may
Mail Order Program continue to receive your
The mail service program is a convenient way for you prescription drugs under this plan.
order medications. Your prescription is reviewed and
dispensed by registered pharmacists and mailed directly to You do not need to enroll in a
your home. separate Medicare D drug plan.

Maintenance Drugs
Up to a 90-day supply of maintenance drugs is
available through the mail order pharmacy. Maintenance
medication is a prescription drug anticipated to be required
for 6 months or more to treat a chronic condition.

Plan C: HDHP Plan In-Network Benefits

Prescription Drug Deductible Integrated with Medical Deductible

Retail: 31-Day Supply 100% after Deductible

Maintenance Drugs through Mail Order: 90- Day 100% after Deductible
Supply

2022 Rangers Baseball LLC (the Texas Rangers) Benefit Guide Page 12