March 6 , 2006
Medco to replace Caremark as pharmacy plan manager
Katherine Hinson is director of HR communications.
Beginning April 1, Medco will replace Caremark as the plan manager for Emory’s prescription drug benefit. The change will provide cost savings for all employees and is in line with the findings of the Benefits Review Committee of 2004–05 and its recommendations, endorsed by University Senate, to President Jim Wagner last spring, which called for greater transparency in the University’s pharmacy contract.
One of the nation’s leading prescription-drug-benefit managers, Medco has a reputation for providing excellent customer service and has an established record with many Atlanta-area employers.
What can you expect from this change?
• There will be no interruption to your prescription plan benefits.
• The drug plan design will not change. In general, most prescriptions will remain in their current tier and co-payment. However, there are some exceptions:
—Approximately 50 prescription drugs have been identified as moving to a lower tier and co-payment.
—Nine drugs have been identified as moving to a higher tier. (However, of these nine drugs, five have a generic equivalent and therefore can be purchased at a lower cost; two are for acute care and are usually a one-time prescription; and two actually cost less than the new co-payment, meaning employees will pay the lower cost, not the co-payment.)
Medco is sending a welcome packet to all Emory health plan members that contain two new ID cards. Beginning April 1, employees should present these cards when filling prescriptions at local pharmacies.
Employees may receive up to a 90-day supply of medication from a participating retail pharmacy. However, to maximize cost savings on ongoing medications, the 90-day supplies can be filled through “Medco By Mail” for the same price as a 60-day supply at retail.
As an additional incentive to use the mail-order feature,
Emory has negotiated a $15 credit toward an employee’s first Medco By Mail prescription (either new or refill) from April 1 through June 30.
To get started using Medco By Mail, just ask your doctor to write a prescription for up to a 90-day supply, plus refills for up to a year (as appropriate). There are three options to fill the prescription:
• mail your prescription(s) along with the “Medco By Mail Order Form” and your doctor’s prescription in the envelope provided;
• ask your doctor to call 888-327-9791 for instructions on how to fax the prescription. Physicians must have the employee’s plan member ID number (printed on the Medco ID card) to fax a prescription; or
• register and order through the Medco website at www.medco.com.
Employees with mail-order prescriptions to be filled prior to April 1 should send them to Caremark, either online or by phone. Caremark is responsible for filling all prescriptions received by March 31 at 11:59 p.m.
Existing mail-order prescriptions with refills available at Caremark will be automatically transferred to Medco as of April 1. Employees will not need to get new prescriptions from their doctors unless the prescription is for a controlled substance, in which case a new prescription is required by federal law.
Find out more
Starting March 10, employees may call Medco member services toll-free at 800-939-3758 to:
• find a participating retail pharmacy;
• get started with Medco By Mail;
• ask about retail and mail-order co-payments;
• ask whether a particular medication will be covered and under what tier; or
• ask how and when to submit a claim for reimbursement.
The Medco website, www.medco.com, will be available beginning April 1, 2006. Employees may review their personal prescription information, refill existing mail-order prescriptions and get detailed plan information, as well as general information on health and well being.
More information on the change is being sent to employees currently enrolled in an Emory health plan. A letter from HR with answers to frequently asked questions, as well as communications from Medco outlining the company’s services and its welcome packet, will be sent to health plan members’ home addresses.