Who is Eligible?

Overview of the Program

Calculation of Earned Credits/ Reimbursement
of Out-of-Pocket Costs

Net Savings

Example

Using Your Earned Credits






Home
 
  
   Who is Eligible?

You are eligible for the Prescription Incentive Program under the following circumstances:

 
  you are covered by prescription drug benefits under the Fund and

 
  you also have "other prescription drug coverage."

"Other prescription drug coverage" means coverage under any insurance arrangement for prescription drug benefits other than coverage under the Fund, including coverage provided by another employer or your spouse's employer. If you and your spouse both have coverage under this Fund through your respective Contributing Employers, you are not eligible for this Program, unless you or your spouse also has "other prescription drug coverage" (for example, through another employer).

                 
Overview of the Program

Under the Program, you can have earned credits recorded to an account on your behalf whenever you or your eligible dependents (including your spouse) use "other prescription drug coverage" to obtain prescription drugs.

Earned credits will be recorded to only one account under the Program for you and your eligible dependents. This single account rule will apply even if both you and your spouse are Fund participants with prescription drug benefits under the Fund. The earned credits recorded to your account for a calendar year may be used to reimburse you for expenses incurred by you and your eligible dependents in that same calendar year, provided that these expenses are not covered under your medical coverage (for example, deductibles, co-payments or coinsurance or other non-covered health care expenses) and are deductible medical care expenses in accordance with the Internal Revenue Code (or approved by the Internal Revenue Service (IRS) in pronouncements). You will also be reimbursed for any out-of-pocket costs such as co-pays, deductibles or coinsurance amounts that you incur as a result of using "other prescription drug coverage."