Page 12 - Intertek 2022 Benefits Guide
P. 12
Home Delivery Prior Authorization
You could save money by ordering up to a 90- Prior Authorization requirements help ensure drugs
day supply of medication. Make fewer trips to the are used in the proper way and in doses that are right
pharmacy and avoid waiting in line. Your medication is for each person as recommended by the U.S. Food
shipped directly to your home with standard shipping and Drug Administration. While most prescriptions can
at no cost to you. be illed immediately by the pharmacy, some require
further review. If you encounter a prescription that
Pharmacists are available around the clock to answer requires prior authorization, your pharmacy will let
your questions. With home delivery, you can go online you know and either the pharmacy or your doctor will
to compare medication pricing, check the timing for work with CVS/Caremark’s Prior Authorization Center
your next order and even set up reminders to take your to determine if your prescription will be approved as
medication on time. requested.
PrudentRx Co-Pay Program
Classic CDHP
In-Network In-Network
Out-of-Pocket Prescription For Classic plan members taking
Maximum Only specialty medications
Employee $1,500 Medical/Rx deductible Specialty medications are used to treat complex
Employee + 1 $3,000 Medical/Rx deductible
Family $3,000 Medical/Rx deductible chronic conditions; they mimic compounds found
Prescription Drugs within the human body. These high-cost oral or
Retail supply limit 30 days 30 days injectable medications are typically biology-based
Generic $10 copay $0 after deductible and highly complex. Intertek is ofering the PrudentRx
Preferred $40 copay $0 after deductible Co-Pay program to help you manage the cost of these
Non-preferred $80 copay $0 after deductible medications by applying inancial co-pay assistance
Mail order supply limit 90 days 90 days
Generic $20 copay $0 after deductible from drug manufacturers. By enrolling in the PrudentRx
Preferred $80 copay $0 after deductible program, your out-of-pocket costs for covered
Non-preferred $160 copay $0 after deductible medications would be $0.
Step Therapy If you currently take one or more medications included
After clinical studies of many diferent drugs, CVS/ in the PrudentRx Program Drug List, you will receive
Caremark has selected certain drugs to be the irst a welcome letter and phone call from PrudentRx with
options tried when treating some conditions. These speciic information about the program and your
drugs have been selected as the “irst step” because medication. The PrudentRx patient advocate will help
studies have shown they are proven to work well for you enroll in the PrudentRx Co-Pay Program, along
most people and are more afordable. Your pharmacy with other available manufacturer copay assistance
will alert you to the step therapy if a prescription you programs.
present is included in a step therapy category.
If you do not enroll in this program, the cost of your
specialty medication will be 30% coinsurance. We
highly encourage you to enroll so that your cost will be
$0.
12
You could save money by ordering up to a 90- Prior Authorization requirements help ensure drugs
day supply of medication. Make fewer trips to the are used in the proper way and in doses that are right
pharmacy and avoid waiting in line. Your medication is for each person as recommended by the U.S. Food
shipped directly to your home with standard shipping and Drug Administration. While most prescriptions can
at no cost to you. be illed immediately by the pharmacy, some require
further review. If you encounter a prescription that
Pharmacists are available around the clock to answer requires prior authorization, your pharmacy will let
your questions. With home delivery, you can go online you know and either the pharmacy or your doctor will
to compare medication pricing, check the timing for work with CVS/Caremark’s Prior Authorization Center
your next order and even set up reminders to take your to determine if your prescription will be approved as
medication on time. requested.
PrudentRx Co-Pay Program
Classic CDHP
In-Network In-Network
Out-of-Pocket Prescription For Classic plan members taking
Maximum Only specialty medications
Employee $1,500 Medical/Rx deductible Specialty medications are used to treat complex
Employee + 1 $3,000 Medical/Rx deductible
Family $3,000 Medical/Rx deductible chronic conditions; they mimic compounds found
Prescription Drugs within the human body. These high-cost oral or
Retail supply limit 30 days 30 days injectable medications are typically biology-based
Generic $10 copay $0 after deductible and highly complex. Intertek is ofering the PrudentRx
Preferred $40 copay $0 after deductible Co-Pay program to help you manage the cost of these
Non-preferred $80 copay $0 after deductible medications by applying inancial co-pay assistance
Mail order supply limit 90 days 90 days
Generic $20 copay $0 after deductible from drug manufacturers. By enrolling in the PrudentRx
Preferred $80 copay $0 after deductible program, your out-of-pocket costs for covered
Non-preferred $160 copay $0 after deductible medications would be $0.
Step Therapy If you currently take one or more medications included
After clinical studies of many diferent drugs, CVS/ in the PrudentRx Program Drug List, you will receive
Caremark has selected certain drugs to be the irst a welcome letter and phone call from PrudentRx with
options tried when treating some conditions. These speciic information about the program and your
drugs have been selected as the “irst step” because medication. The PrudentRx patient advocate will help
studies have shown they are proven to work well for you enroll in the PrudentRx Co-Pay Program, along
most people and are more afordable. Your pharmacy with other available manufacturer copay assistance
will alert you to the step therapy if a prescription you programs.
present is included in a step therapy category.
If you do not enroll in this program, the cost of your
specialty medication will be 30% coinsurance. We
highly encourage you to enroll so that your cost will be
$0.
12
