DRUG
PROGRAM – RETIREES -- Mandatory Generic Reimbursement
The member, his or her spouse,
and children (up to their 23rd birthday) can use the Benecard Services
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 $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 psychotrophic 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 Services
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 psychotrophic drugs
have a 45% co-pay.
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 (NPA Express Scripts).
Contact the DEA office or call NPA Express Scripts at (800) 467-2006
for more information. You may also visit NPA’s Express Script Web
site at www.e-npa.com
Click
here to download the Benecard Services Direct Reimbursement Claim
Form