Page 7 - Washington Nationals 2023 Benefits Guide -10.26.22_Neat
P. 7
80/60 PPO PRESCRIPTION DRUG 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 Medicare Part D
dispensed by either pharmacy or designated mail
service The company’s prescription
drug plan is creditable
Retail Program coverage. That means it
The retail program provides up to a 31-day supply of meets and exceeds
medication. Simply present your ID card at a Medicare Part D
participating pharmacy nationwide and pay the requirements and the
appropriate co-pay for your medication. benefits offered by most
Medicare Part D plans. If
Mail Order Program you are eligible for
The mail service program is a convenient way for Medicare, you may
you order medications. Your prescription is reviewed continue to receive your
and dispensed by registered pharmacists and mailed prescription drugs under
directly to your home. this plan. You do not need
to enroll in a separate
Maintenance Drugs Medicare D drug plan.
Up to a 90-day supply of maintenance drugs is
available through the mail order pharmacy.
Maintenance medication is a prescription drug Additional information is
anticipated to be required for 6 months or more to available on the intranet.
treat a chronic condition.
80/60 PPO Prescription Plan
Retail Pharmacy Copayment Mail Order Copayment
Prescription Tier (31-day supply) (90-day supply)
Generic $10 $20
Brand Name $20 $40
Non-Formulary Brand Name $35 $70
2023 Washington Nationals Benefit Guide Page 7
