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PRESCRIPTION COVERAGE
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
Retail Program The company’s prescription drug
The retail program provides up to a 31-day supply of plan is creditable coverage. That
medication. Simply present your ID card at a participating means it meets and exceeds
pharmacy nationwide and pay the appropriate co-pay or Medicare Part D requirements and
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
prescription drugs under this plan.
The mail service program is a convenient way for you You do not need to enroll in a
order medications. Your prescription is reviewed and separate Medicare D drug plan.
dispensed by registered pharmacists and mailed directly to
your home.
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.
PPO Prescription Plan In-Network
$150 Individual Deductible
Prescription Drug Deductible $450 Family Deductible
(separate from medical)
$20 Generic
Retail: 31-Day Supply $30 Brand
$60 Non-Formulary Brand
$40 Generic
Maintenance Drugs through Mail Order: 90- Day
Supply $60 Brand
$120 Non-Formulary Brand
2023 Down East Wood Ducks Benefit Guide Page 8
