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COMET MARKETS FULL TIME EMPLOYEES |
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Eligible members receive a Drug Identification Card, which must be available to identify themselves to participating pharmacists. The categories of drugs covered by the plan and your co pays are shown in this chart. |
| Prescription Drug Category | What You Pay* |
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(obtain a 34-day supply) |
(obtain a 100-day supply) |
| Generic - Non Maintenance | $3.00 Co-pay | $3.00 Co-pay | Generic - Maintenance | $3 co-pay or 10% of the cost of the drug whichever is greater | $3.00 Co-pay |
| Brand ** - Non Maintenance | $5 co-pay (plus the difference in the cost between the generic drug and the brand name drug, if applicable) | $5 co-pay (plus the difference in the cost between the generic drug and the brand name drug, if applicable) |
| Brand ** - Maintenance | $5.00 co-pay or 10% of the cost of drug whichever is greater (plus the difference in the cost between the generic drug and the brand name drug, if applicable) | $5.00 co-pay or 10% of the cost of drug whichever is greater (plus the difference in the cost between the generic drug and the brand name drug, if applicable) |
| *You can now obtain your maintenance drugs up to a 34-day supply for a one co-payment at retail. **If there is no generic available, there will be no difference in cost between brand and generic. PRIOR AUTHORIZATION REQUIRED FOR SOME DRUGS A small number of prescriptions require advance approval before they will be covered by the plan. For Prior Authorization, you, your doctor or your pharmacist must call 1-800-467-2006. If you do not obtain pre-approval, the drug may not be covered. Mail - Order Prescriptions The mail-order program offers a convenient, cost-saving and timesaving way to order prescriptions that you take on a regular basis, such as high blood pressure medicine. These drugs are also called "maintenance drugs" because they are used to maintain your health and/or control a chronic medical condition for a long period of time. Maintenance drugs are usually prescribed for 100 days. Your doctor can write your maintenance prescription with refills for up to one year. The mail-order program is administered by Remote Express Distribution Network (RxDN). You simply send your prescription and co-payment to RxDN. They mail the medicine to you, usually within 7 business days (try to leave 2 weeks for delivery). Getting a New Mail-Order Prescription Filled for the First Time Fill out the mail-order form and send it to RxDN along with the prescription from your doctor and the applicable co-payment. The co-payments for mail-order drugs are $3 generic and $5 brand name plus the difference in the cost between generic drug and the brand name drug, if applicable. Call RXDN 1-800-800-8769 Refilling Mail-Order Prescriptions Your Doctor can write your mail-order prescription with refills for up to one year. If you already have a prescription on file with RxDN, you can refill the prescription over the phone instead of sending another form. RxDN will bill you directly. Getting Prescriptions Filled While Away From Home NPA has over 50,000 pharmacies nationwide. You should have no problem filling a prescription at a participating pharmacy no matter where you are traveling. Simply present your I.D. card. NPA pharmacies are online via computer with NPA and will submit your claim electronically at the time the prescription is filled. You pay only your applicable co-payment. If you do not use a participating pharmacy, you must pay the full cost of the prescription, usually at the full retail cost - you will not benefit from the "plan discount." Call the Fund office to see if you can be reimbursed, and the eligible amount. If the prescription is reimbursable, the Fund office will send you a claim form. You must complete and send the form to NPA no later than 30 business days from the date the prescription was dispensed. |