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Calculation of Earned Credits/ Reimbursement of Out-of-Pocket Costs Net Savings Example Using Your Earned Credits Important Limitations Claim Forms and Deadlines Medical Expenses Reimbursable Under the Program Home |
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After you or your eligible dependents use "other prescription drug coverage" to obtain prescription drugs, you should submit a Prescription Incentive Program claim form to the Fund office. Attach your pharmacy receipts for each prescription filled showing the amount of your out-of-pocket costs and information which will identify the prescription drug. The Fund office will then take the following steps: The earned credits to be recorded to your account will be a percentage of the "net savings" to the Fund as a result of your use of the "other prescription drug coverage." The Fund's "net savings" is determined as follows: 1. The amount it would have cost the Fund to provide you or your eligible dependent with that prescription drug under the Fund's plan (the Fund's cost, less the co-pay and other costs you would have incurred under the Fund's Prescription Drug Benefits), minus 2. The amount of any "out-of-pocket" costs (co-pays, deductibles, coinsurance) that the Fund reimburses you for using your "other prescription drug coverage." Your earned credits will be a percentage of the "net savings" to the Fund. If you obtained your prescription drug at a Preferred Pharmacy or under the Fund's mail order program, the earned credits to your account will be an amount equal to fifty percent (50%) of the "net savings" to the Fund. If you obtained the prescription drug from a Non-Preferred Pharmacy, the earned credits to your account will be an amount equal to forty percent (40%) of the "net savings" to the Fund. See the section titled "Prescription Drug Benefits" for a list of Preferred Pharmacies. |