Prescription Drug coverage

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Prescription Drug
coverage
Part of the Medical Plan
1
Special rules for Maintenance Drugs
A Maintenance Drug is an ongoing drug that
is refilled month after month. Common
examples are high blood pressure
medication, cholesterol drugs and birth
control pills
Due to the costing and predictability of
Maintenance Drugs, all such refills MUST
be obtained through the CMH Pharmacy
2
Purchase your Rx
drugs here
Pharmacy located at CMMC
NOTE: Non-maintenance drugs and the initial 30
day maintenance drug fill may be purchased at
a retail pharmacy
•
•
•
•
Hannaford
Rite Aid
CVS
Wal*Mart, etc.
3
Where is the Pharmacy located?
1.
2.
3.
4.
5.
6.
Southern end of the hallway on the
second floor of CMMC
Open from 7:00 a.m. to 5:00 p.m.
Monday through Friday
Phone: 795-7177
Fax: 795-7552
E-mail: employpr@cmhc.org
4
How do I order my Rx?
If you use a CMMF doctor, your Rx can
be submitted electronically
You may also do the following:
1.
2.
3.
4.
Present your Rx to the Pharmacy in person
Ask your doctor to call the Rx in (795-7177)
Ask the pharmacy to call your provider
Email the pharmacy employpr@cmhc.org
5
Why should I use the CMMF
Pharmacy instead of another?
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2.
3.
4.
You will save money on your co-pays (EVERY co-pay
is less expensive when using our Pharmacy)
The CMH Medical Plan will save money - the
premiums established by our medical plan reflect
nearly $600,000 in savings due to employees using
the in-house pharmacy
We are a 340B Pharmacy which, under federal
guidelines, our purchase rates are typically lower than
retail pharmacies
Maintenance Drug refills are required to be purchased
through the CMH Pharmacy
6
What are the level of drugs?
Drugs fall into four categories:
1.
2.
3.
4.
Certain over-the-counter drugs (i.e.
prilosec)
Generic drugs
Preferred Brand name drugs
Non-preferred Brand name drugs
7
May I purchase a 90 day supply?
1.
2.
You may purchase your Rx in various
increments. Your doctor may prescribe
dosages of any number of days (typically
a 30 day, 60 day or 90 supply)
For “maintenance drugs”, those taken
continuously and for long periods of
time, purchasing in 90 day increments
seems the most practical
8
Conveniences of using the
CMH Pharmacy
There are a number of reasons to use the inhouse pharmacy rather than retail:
1. ALWAYS lower co-pays
2. Free mail-order to your home
3. Ease of calling or emailing in the
prescription
4. The plan saves cost contributing to
affordable plan premiums
What are the co-pays?
30 Day supply @ CMH Pharmacy
OTC
Generic
Preferred
In-house $ 4
$ 4
$15
$35
Outside
$10
$30
$50
$10
Non-preferred
10
What are the co-pays?
60 Day supply @ CMH Pharmacy
OTC
Generic
Preferred
In-house $ 8
$ 8
$30
$70
Outside
$20
$60
$100
$20
Non-preferred
11
What are the co-pays?
90 Day supply @ CMH Pharmacy
OTC
Generic
Preferred
In-house $10
$10
$45
$95
Outside
$30
$90
$150
$30
Non-preferred
12
How do I pay for my Rx?
In-house pharmacy:
1.
2.
3.
Sign for payroll deduction
Use your Benny Card
Credit card payment
Outside pharmacy:
1.
2.
3.
Benny Card
Cash
Credit card payment
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