Changes to the Prescription Drug Plan for 2008
For 2008, The Travelers plan will continue to incent you to take advantage of the value and convenience offered through home delivery (mail order pharmacy) whenever you’re taking a drug on an ongoing basis.
This site was created to estimate your out-of-pocket prescription drug costs for 2008. In a few simple steps, you'll be able to:
Review the details of your Prescription Drug Benefit, including participating pharmacies and a list of drugs covered by your health plan's formulary
Build a list of the prescription drugs required by you and your family
Learn how much each drug may cost and estimate your out-of-pocket costs for the year
Determine how much money you might save by switching to a generic drug or by ordering your prescriptions through Express Scripts Mail Service
Learn about the next steps you can take to effectively manage your out-of-pocket costs
Preferred Home Delivery Policy
Under this policy, you are allowed to receive up to a 1-month supply of a maintenance medication two times from any participating retail pharmacy. After two fills, you will need to make a decision to either use the Express Scripts Mail Order Pharmacy, or continue to use a retail pharmacy for refills. Any additional retail refills of the same maintenance medication will be subject to an additional 10% coinsurance above the regular coinsurance (e.g. generic, formulary brand, or non-formulary brand). Once the initial maintenance medication prescription is filled, you will receive a reminder letter from Express Scripts about this program.
The Preferred Home Delivery policy eliminates the cost difference between retail and mail pharmacy pricing for maintenance medications, while giving you the opportunity to decide where you would like to source your maintenance medications. Additional information on the Express Scripts mail order pharmacy is available at www.express-scripts.com.
Selected medications may not be available through the mail order pharmacy due to manufacturer direction or medical policy. You can review the cost differences between retail and mail order prescriptions for a specific medication by visiting either of the Express Scripts Web sites described earlier. For specific questions concerning Express Scripts, call 877.494.7472.
Click here here to see the full list of maintenance drugs subject to this policy.
Generics Preferred Policy
Effective for the 2008 plan year, the Generics Preferred policy will be expanded to all prescription categories with the exception of Coumadin and Synthroid:
The policy is triggered when a member receives a brand name prescription for a medicine when a chemically equivalent generic alternative is available. If a brand name drug is dispensed rather that an available chemically equivalent generic drug, an ancillary charge is applied in addition to the member’s 10% coinsurance. The ancillary charge is the difference in cost between the brand and generic drug. Ancillary charges apply and are the responsibility of the member, regardless of whether the “Dispense as Written” box is checked by the doctor. The ancillary charge does not apply towards the maximum per prescription ($85 retail, $170 mail) or the $2,000 per person out-of-pocket maximum.
If you or your family member's physician feels it is medically necessary to continue to receive the brand name version of the medication instead of the generic, the physician can call Express Scripts’ Prior Authorization Line at 800.417.8164 before obtaining your prescription. If medical necessity is approved by Express Scripts, you pay the non-formulary coinsurance for the prescription.
Specialty Medicine Program: CuraScript
Specialty medications are covered up to a 30-day supply through Express Scripts specialty medication pharmacy company CuraScript. A partial list of conditions that may result in these specialty medications includes arthritis, cancer, hepatitis, infertility, migraines, RSV, and multiple sclerosis. Under the specialty program, members are allowed two initial fills per medication at a local retail pharmacy. After that, the medications will be filled via the CuraScript mail order pharmacy. Specialty medications are subject to the same coinsurance (minimums and maximums) as retail prescriptions with the exception of infertility medications which are covered at 50% except for the High Deductible Plan. If you have questions on this program you can contact CuraScripts at 800.278.0980.
Click here to see the full list of specialty injectable drugs subject to this policy.
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