8.3 RETAIL PHARMACY PROGRAM
The Retail Pharmacy Program is designed to meet 1) your short-term (a 34-day supply or less) prescription drug needs and 2) effective April 1, 2007 your maintenance medication needs (a 90-day supply) on an on-going basis based on the applicable mail order co-payments. When your prescription is filled at a participating pharmacy, you will have to pay only your copayment to the pharmacy. You will not have to file a claim form and wait for reimbursement, as the retail pharmacy will bill the Plan directly for the remainder of the cost of your prescription. If you do not have a list of participating pharmacies (or a list of approved out-of-network pharmacies), contact the Trust Customer Service Office.
After receiving a short-term prescription from your Physician, go to any participating pharmacy and present your pharmacy ID card to the pharmacist who will check your eligibility for coverage from a list supplied by the Plan. You may receive up to a 34-day supply of medication per prescription or a 90-day supply for maintenance medications through the Retail Pharmacy Program. You must have taken at least 75% of your prescription before a refill will be covered by the Plan.
Beginning April 1, 2007, through the HealthTrans Discount 90Rx program, after obtaining a long-term prescription (greater than a 34-day supply) from your physician, you may visit a preferred participating pharmacy and fill up to a 90-day supply of select maintenance medications. A list of maintenance medication can be obtained by visiting the web site.
|