Prescription Drug Benefits

Prescription Drug Benefits

Eligibility

If you are enrolled in the POS Medical Plan (Aetna) or the PPO Medical Plan (BCBS of GA), you and your covered dependents are enrolled in the Medco Pharmacy plan and can have a prescription filled at a participating pharmacy, or use a mail-in service through Medco.

Aetna Healthfund HRA and Aetna HDHP prescriptions are administered by Aetna.

Tier Zero for 2009

For 2009, generic prescription drugs used to treat congestive heart failure, diabetes, high blood pressure and cholesterol will stay at Tier Zero. The co-pay for Tier Zero prescription drugs are waived to help make these drugs more affordable. Emory pays 100% and plan participants will pay $0 for a 30- or 90-day generic prescription supply. The Tier Zero structure is included for Aetna POS, Aetna HealthFund HRA and BCBS PPO Medical Plans.

Some drugs that are included in Tier Zero are:

• Hydrochlorothiazide
• Furosemide
• Glyburide
• Simvastatin

Here is a complete list of all Tier Zero drugs.

Co-pays for mail-order drugs.

• Keep in mind that you still pay less for a 90-day supply through mail-order than by purchasing three (3) 30-day supplies via retail

Generic Drugs — A Great Value
Which ever medical plan you elect, using generic drugs is a great way to lower your prescription drug costs if your physician prescribes a brand-name drug and does not specify Dispense as Written (DAW). Ask your pharmacist if a generic version is available. If your physician does check the DAW box, the pharmacist is required to dispense the brand-name drug. However, it is important to know that you will pay the higher brand-name drug co-pay/co-insurance, as well as the difference in cost between the generic and brand-name drug.

(Please be aware Tier Zero will appear as Tier 5 on some vendor information.)

How to Fill Your Prescription

Use your Medco Pharmacy Card at a participating pharmacy when you have a prescription filled.

To begin using the Mail-In Prescription service:

• Step 1: Call Medco Prescription Service at (800) 473-3455. Customer Service will assist you in getting your prescription to Medco by mail or fax.
• Step 2: Mail your written prescription with the Medco Prescription Mail Order Form or have your doctor fax in your prescription with the Medco Prescription Fax Form. Make sure your information is on the forms.
• Step 3: Mail to: Medco Health Solutions of Tampa 4

  P.O. Box 30493 Tampa FL 33630-3493

  For the Aetna HealthFund HRA or Aetna HDHP, please contact Aetna at www.aetna.com/docfind/custom/emory or (800) 847-9026

Note: Refer to Benefits Terminology for an explanation of terms, if necessary.

Vendor Contacts

Medco
(800) 939-3758

How the Plan Works

Emory's prescription drug benefits for the Aetna POS and BCBS-GA PPO Plans are provided by Medco and enable you and your covered dependents to have prescriptions filled at a participating pharmacy or to use the mail service program.

Prescription drugs are divided into five tiers which affect the cost of the drug. Having the prescription filled at a retail pharmacy versus using the mail service also affects the cost.

* Your plan documentation provides you with a booklet listing the most common drugs and their tier level. Your physician and pharmacist can also provide information on the tier level for specific drugs.

** Mail Order - Maintenance medications (taken daily) should be issued by your physician and remitted to Medco as a 90 day supply, refillable 3 times.

You can take advantage of Medco's mail order program to obtain up to a three-month supply of maintenance drugs for the cost of two retail co-pays. You should request two prescriptions from your doctor; the first, for a 30-day supply to fill immediately at a participating pharmacy and second, for a 90-day supply to be filled through the mail.

Note:

• If the cost of the drug is less than the co-pay, you pay the cost of the drug.
• At retail, when a generic drug is available, but the brand name is dispensed for any reason, you pay the brand co-pay plus the difference between the brand-name drug and the generic drug.

Plan Information Documents

Benefits Terminology	Tier Zero
Medco Pocket Formulary Guide	Tier Zero in detail

Plan Forms

Medco Prescription Mail Order Form	Medco Prescription Fax Form
Medco Prescription Claim Form

Emory University Benefits

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Disclaimer

Emory reserves the right to terminate, suspend, withdraw, amend or modify the Plan in whole or in part at any time. Further, Emory reserves the right to terminate or modify coverage for any group of employees, active or retired and their dependents or a class of dependents at any time.