TRB: Retiree Prescription Drug Benefit Effective January 1, 2015

Retiree Prescription Drug Benefit Effective January 1, 2015

 

The Teachers’ Retirement Board prescription drug plan will change January 1, 2015.  The new plan is an Employee Group Waiver Plan which is an enhanced group sponsored Medicare Part D prescription drug plan.  This will increase our Federal funding and provide additional discounts on the cost of name brand drugs.

 

To help you understand the changes we have placed the information in this Frequently Asked Questions (FAQs) format.  We hope that the FAQs below will provide you with the most relevant changes that impact your prescription benefits. 

 

Who will be the Pharmacy Benefits Administrator?

Effective January 1, 2015, Express Scripts will replace CVS Caremark as our Pharmacy Benefits Administrator.

 

How will the change to Express Scripts Medicare® (PDP) for Connecticut Teachers’ Retirement Board impact me?

  • The change will broaden your network of pharmacies allowing you to fill prescriptions at more locations.
  • The number of preferred covered drugs is larger with Express Scripts reducing the cost on some prescriptions.
  • Your premium decreases by $5 per month for 2015 and is likely to decrease next year as well.

Is there a change to my copayment?

There will be no cost for generic drugs after the deductible is satisfied.  All other copayment percentages will remain the same.

 

What will my annual calendar year deductible and member out-of-pocket maximum costs be for prescriptions, effective January 1, 2015? 

  • Deductible:                                $320 (Effective 1/1/2015)
  • Member Out-of-Pocket Maximum:   $750
The most you will pay during the 2015 calendar year for your covered prescription drugs under Express Scripts Medicare will be $1,070.

 

Why has the deductible increased from $250 to $320?

The $320 deductible is consistent with the Medicare Part D deductible.  This increase should be offset by the lower premium costs and the elimination of copayments on generic drugs.

 

How will maintenance drugs be handled?

You can have your 90-day maintenance drugs filled by the Express Scripts mail order (home delivery) pharmacy or at many network retail pharmacies with the same coinsurance as you would through the home delivery pharmacy. Pharmacy prices vary substantially so it always pays to comparison shop.  Mail order is often less expensive.  Most pharmacies are in the network.  We recommend you call your pharmacy to confirm that they participate in the network.

 

What do I need to do to enroll in the new prescription program?

If you are currently enrolled in the TRB prescription benefit plan, you will be automatically enrolled into Express Scripts.

   

What do I need to watch for as we move to Express Scripts?

Early October                  Express Scripts dedicated telephone line opens

                                    1-844-433-4883, 24 hours a day, 7 days a week

 

October                          A Benefit Overview and Opt out form.

 

December                        A Welcome Kit

 

Per federal law, your welcome kit will include the following:

  • Member ID Card
  • Quick Reference Guide
  • Welcome letter
  • Benefit Overview
  • Pharmacy Directory
  • Evidence of Coverage Document
  • Formulary list
  • Home Delivery Order Form

It is crucial that you watch for, read and retain all the information in your welcome kit.  The above Teachers’ Retirement Board logo and the Express Scripts logo will appear on the outside of the Welcome Kit envelope to identify the mail as legitimate.

 

Who do I call if I have any questions about my prescription drug benefit?

You can call Express Scripts at 1-844-433-4883 for general information about the plan. You may also access information online upon your effective date to www.express-scripts.com.

 

I use maintenance drugs and currently use mail order (home delivery).  If I want to continue using mail order, will I need a new prescription?

If you have a prescription on file, the additional refills will be automatically transferred for most drugs.  The exceptions include controlled substances and some specialty drugs.

 

How do I find participating pharmacies?

Participating pharmacies will be included in your welcome kit that you receive along with your new id card.  You should find that the number of participating pharmacies has increased.



Content Last Modified on 10/23/2014 3:35:03 PM