DRUG PROGRAM – RETIREES -- Mandatory Generic Reimbursement
The member, his or her spouse, and children (up to their 23rd birthday) can use the Benecard PBF drug card at participating pharmacies with a co-payment schedule as follows:
$10 or less for generic prescriptions (not to exceed the cost of the medication);
$10 or 30% for single source brands;
$10 or 30% for multi-source brands, plus the difference between the cost of the brand and generic drugs.
There is an annual plan year deductible (July 1st through June 30th) of $50 per individual and $150 per family prior to plan benefit coverage.
There is an $11,000 cap for a family per year. Prescription drugs that have an over-the-counter equivalent are not covered under our drug plan.
Asthma and psychotropic drugs have a 45% co-pay.
Children from the ages of 19 to the date of their 23rd birthday (who have proper student verification on file with the DEA) will now be eligible to use the Benecard PBF card to obtain their prescriptions, and simply pay the co-payment. Student verification must be submitted to the DEA twice each year for the fall and spring sessions. Please remember to submit student verification for the fall semester (which covers the time period between 9/1 and 2/28), and the spring semester (which covers the time period between 3/1 and 8/31).Click here for the DEA Student Verification Form.Mail order -- The maintenance (continuous medication) drug program entitles you to a three (3) month supply with a co-payment schedule per prescription as follows:
$10 or 30% for generic prescriptions;
$10 or 30% for single source brands;
$10 or 30% for multi-source brands, plus the difference between the cost of the brand and generic drugs.
Asthma and psychotropic drugs have a 45% co-pay.
You may contact Benecard PBF directly at 1-888 DEA NYPD or the DEA health benefits office should you have any questions regarding your prescription drug benefits.
The City of New York is covering certain prescriptions (injectibles and chemotherapy drugs) under the PICA program. This program is available to all non-Medicare members who are enrolled in a City-sponsored Health Plan and is administered by Express Scripts. Contact the DEA health benefits office or telephone Express Scripts at (800) 467-2006 for more information. You may also visit Express Script’s Web site at www.express-scripts.comClick here to download the Benecard Services Direct Reimbursement Claim Form
Click here to download the Benecard PBF Mail Order Form
Click here to download a list of the Top 10 Brand Name Drugs and their Generic Equivalents.