Page 14 - Texas Rangers 2022 Front Office Flipbook

PRESCRIPTION DRUG COVERAGE PLAN D

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.

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

Plan D: PPO Plan In-Network Benefit

$150 Individual Deductible
Prescription Drug Deductible $300 Family Deductible
(Separate from Medical)

Retail: 31-Day Supply 30% (Min $10, Max $100)

Maintenance Drugs through Mail Order: 90- Day
Supply 30% (Min $20, Max $200)

2022 Rangers Baseball LLC (the Texas Rangers) Benefit Guide Page 14