Prescription Drug Coverage
2012–2013 Benefits Open Enrollment
As of July 1, 2012, Penn's prescription drug carrier will change from CVS/Caremark to Medco. Click here for more information.
If you enroll in any of Penn's medical plans, prescription drug coverage is provided for you and your enrolled dependents. The prescription drug plan is administered by CVS Caremark Prescription Services for all medical plans. However, the plan structure differs depending on which medical plan you select.
The amount you pay for prescription drugs depends on how you use your coverage and the type of prescription you fill (generic, brand name with or without a generic equivalent, or a maintenance medication).
- When you go to a retail pharmacy, you'll pay less if you use a participating CVS Caremark pharmacy (e.g., CVS, Giant, HUP Pharmacy, Rite Aid, Kmart, Pathmark, and Genuardi's).
- You can use the mail order program for long-term maintenance medications. It offers several advantages such as three-month supplies, home delivery (you can also pick prescriptions up at a CVS pharmacy) and lower minimum and maximum coinsurance amounts.
- If you're able to take a generic drug, you'll save money—not only will you pay a lower coinsurance amount, but that lower coinsurance is a percentage of a lower base price for the drug.
Cost structure for current plan year (July 1, 2011–June 30, 2012)
Cost structure for next plan year (July 1, 2012–June 30, 2013)
The amount you pay for prescription drugs depends on whether your prescription is a preventive generic drug or some other drug type. When you take generic preventive drugs, you’re not subject to the deductible. For all other drugs, you must reach your deductible before the plan begins to pay benefits.
Cost structure for current plan year (July 1, 2011–June 30, 2012)
Cost structure for next plan year (July 1, 2012–June 30, 2013)
If you're enrolled in the PennCare/Personal Choice PPO, Aetna Choice POS II or Keystone/AmeriHealth HMO plans, your prescription drug coverage for maintenance medications works as follows:
- If you get 34-day supplies of your maintenance medication at any network retail pharmacy, you’ll pay the normal coinsurance and minimum and maximum copays for up to the first three fills.
- After the first three fills, if you continue to get 34-day supplies at any network retail pharmacy (including CVS), you’ll pay double the normal coinsurance amount as well as double the minimum and maximum coinsurance payments.
- You can save money by filling your maintenance medications in 90-day supplies through mail service or at a CVS pharmacy. Whether you choose delivery or pick up, you will pay the same coinsurance/copay.
If you're participating in the Health Care Pre-Tax Expense Account, getting reimbursed for your prescription drug expenses is easy. Your expenses are automatically paid from your Health Care Pre-Tax Expense Account. You don’t have to file a claim to be reimbursed. Click here for more information. If you’d prefer to opt out of the automatic reimbursement process, just call the Penn Benefits Center at 1-888-PENNBEN (1-888-736-6236).
Use your ExtraCare Health Card to save money on many of the health-related items you need on a daily basis. No matter what medical plan you’re enrolled in, the ExtraCare Health Card gives you 20% savings on CVS/pharmacy brand items that are health-related and eligible for reimbursement under the Health Care Pre-Tax Expense Account or Health Savings Account (HSA). It can be used by you, your spouse and your dependents at any CVS/pharmacy store. If you already have a regular CVS ExtraCare card, the ExtraCare Health Card can replace it. You'll still enjoy all the benefits of your ExtraCare card, plus the additional 20% savings on CVS/pharmacy brand health-related items.
This notice has information about your current prescription drug coverage with Penn and your options under Medicare’s prescription drug coverage. It's intended to help you decide whether you want to join a Medicare drug plan. Download a copy of the Creditable Coverage Notice.
Questions? Contact CVS Caremark at 1-800-378-0802 or visit their website.