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The
new National Agreement contains changes in our benefit packages. In addition,
Local 2195 members recently received a letter concerning changes in the
health care program. These changes for Prescription Drug Co-Payments and
PPO office visits are effective January 2004. Some of these changes have
been communicated through the Steering TOday and Southern Accents newsletters.
However, the information that was available at that time has since been
found to be slightly different. One significant item is that of mail order
prescription drugs. Even though list have been made available concerning
the mandatory mail order drugs, the National Benefit Center is urging
everyone to mail order all maintenance prescription drugs. This would
include any prescription drug you take on a continual basis.
Prescription Drug Co-Payments
Co-payments on prescription drugs will be increased to $5.00 for generics
and $10 for brand names. This will apply for Traditional and PPO plans.
Co-payments for those already retired will stay at current levels. The
co-payment for using the Mail Order Program will increase to $5.00 for
active and retired members (who retire after October 06, 2003) beginning
in January 2005. This change was covered in page 5 of the National Agreement
highlights.
PPO Office Visit Charges
Several years ago the option of a PPO plan was added for members. This
option includes partial coverage for standard office visits. Effective
January 2004, the co-pay for an office visit will increase to 50% for
those enrolled in a PPO plan. In addition, PPOs will be restructured on
narrower networks beginning in 2005. These changes were covered on page
4 of the National Agreement Highlights.
Mandatory Mail Order for Certain Drugs
The Mail Order pharmacy has been an option for certain maintenance drugs
for sometime. Beginning January 2004, the use of mail order will be mandatory
for an active or retired member “maintenance” drugs for chronic
conditions (such as hypertension, diabetes, high cholesterol and etc.)
Members and their families will be able to save significant out of pocket
costs by using the Mail Order Program since they will only be paying a
$2.00 co-pay for a 90 day supply of drugs. Effective January 2005, the
co-pay increases to $5.00 for a 90-day supply. Under the Mail Order Program,
a person may get a prescription and two refills at a retail pharmacy before
switching to the mandatory Mail Order Program. The mail order pharmacy
provisions were covered on page 5 of the National Contract Highlights.
The Mail Order Pharmacy will automatically send the generic form of your
prescription drug if one exists. If a prescription drug is a single source
drug, meaning there is no generic equivalent, then a brand name drug will
be covered.
The form can be faxed by your doctor or mailed along with the prescription
by you. Forms can be found in the Benefits Office of each plant, or cab
be downloaded from the Medco website at http://www.medcohealth.com or
the Local 2195 Website at http://www.uawlocal2195.org. It might be a good
idea to ask your doctor’s office to keep a copy of the form on file
in your chart for use. Also, make certain that your doctor specifies a
90-day supply on the prescription. Most patients can receive up to a 90-day
supply and two refills. You will need to call each time to receive your
refill and it is recommended that you call prior to insure on time delivery.
Each prescription you receive will have the eligibility date for refills.
Make certain you call after this date.
You can register for Medco’s on line services. This system will
allow you to print forms and check the status of your orders or place
an order for a refill provided you have a refill on file for your prescription.
Visit their web site at http://www.medcohealth.com to register. When asked
for your membership number, enter your Social Security number. You will
also be asked for your date of birth. For additional questions, see the
benefit representative in your plant.
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