SAW Consortium Prescription Drug Coverage Effective 1/1/17 RxBenefits efits, , Inc. advocacy. expertise. service . 800.334.8134 RXBENEFITS . COM
Your r Prescri scriptio ption n Drug Cover erage age What’s Changing? • • Effective 1/1/2017, your prescription During open enrollment, you may call drug coverage will be provided through RxAssure to find where your current Express-Scripts (ESI). Aetna will drugs fit on the new formulary. continue to provide your medical • In addition, before 1/1/17, ESI will send coverage. you a notification in the mail if your • RxBenefits will administer your drug is not covered under the new pharmacy plan. This means you will formulary. Alternatives will be offered. contact RxAssure (member services) • Mail order member will require a new for prescription drug questions. prescription, as well as will need to • ESI offers over 68,000 pharmacies, register with ESI’s Home Delivery including most national chains and Prog rogram. many independents • Current plan copays will not change; however, there is a change in formulary | RxBenefits | SAW (meaning how drugs are covered). 2
What at Does es This is Mean to You? New Pharmacy ID Card • • The processing information and Before 1/1/17, all enrolled contact phone numbers on your employees will receive a new Express-Scripts ID card will no not pharmacy ID card from Express be the same as your previous Aetna Scripts. This will be a separate med/rx ID card. card from your Aetna medical card. The new information is: • • RxBIN: 610014 Please make sure you show • RxGroup: 35242Rx this new ID card to your • Provider Pharmacy Help Desk: pharmacy on and after 1-800-922-1557 1/1/2017. • RxAssure Member Services: 1-800-334-8134 | RxBenefits | SAW 3
What t To Do Prior or to Januar ary y 1 st st , 2017 • • Refill all retail and mail order Set up mail order through Express prescriptions through your current Scripts Aetna coverage to ensure you have – Mail Order can take up to two adequate supply in case of transition weeks for the initial order, so issues. members should make sure to • If you have particular prescription have enough medication on drug needs, call RxAssure to identify hand to last until delivery. any impact in coverage. • Look for your new ID card and welcome packet in the mail. | RxBenefits | SAW 4
Speci cialty lty Medic ication ation • Specialty medications are covered though Accredo (Express Scripts Specialty Pharmacy). • Prior to 1/1/2017, you will receive notification if your specialty drug is not covered under ESI, and what action needs to be taken. • Be proactive – call RxAssure during Open Enrollment to ensure you know how your current prescriptions will be covered. • Specialty medications may require prior authorization and quantity limits may apply. • Specialty medications are limited to a 30-day supply. DURING OPEN ENROLLMENT: | RxBenefits | SAW Call RxAssure, your Member Services Team, to discuss how your prescription will be covered. 5
Mail Or Order • Member will utilize ESI ‘s Home Delivery Program for their mail order prescriptions. You will need to register thru the website, and provide your new member number and payment information. • New prescriptions after 1/1/17 can be attached to a completed mail order form and mailed to ESI. • Mail order forms will be provided at the Open-Enrollment Events Send completed Mail Order forms to: ESI Home Delivery can be reached at 87 877.5 7.503 03.40 4073. Express Scripts | RxBenefits | SAW P.O. Box 66564 St Louis, MO 63166-6564 NOTE: : Mail Order can take up to two weeks for the initial order, so members should make sure to have enough medication on hand to last until delivery. 6
Your ur Member er Se Servic rvices es Team m (RxAssur Assure) e) RxBenefits is your pharmacy benefit administrator (PBA) effective 1/1/17. RxB • We partner with the country’s largest Pharmacy Benefit Managers (PBMs) to bring greater discounts, enhanced access, and improved Member Services to our clients and their employees. Your coverage will be with Express Scripts. • You will have access to RxAssure , our Member Service Team. We are available Monday – Friday, 8:00 am till 7:00 pm EST to assist you with questions such as: Can you help me Can you assist me with my claim transition my questions? Is my drug covered? mail order What will it cost? scripts? Are there lower cost Is my pharmacy alternatives? in the network? | RxBenefits | SAW • Calls received after hours and weekends will allow members to leave a message or be routed to Express Scripts Member Service; which is 24/7. 7
Mobil ile Apps: myDr DrugCosts ugCosts (offered through RxBenefits) Research ch drug costs ts and alterna rnati tives ves A simple web based tool to help reduce the costs of your prescription drugs EASY TO USE PLAN SPECIFIC DRUGS COSTS Tailored to your Company Your Mail Order Cost Your See options specific to your health plan See your out-of-pocket cost & Company information about home delivery of your Quickly Find a Drug medications Your Plan Cost Type a few letters to lookup your drug See your out-of-pocket cost and further information with in-network Pharmacies WAYS TO SAVE Cash Price Generic Equivalents See the cash price if you bought without Know when you can switch to the generic insurance (non-covered or out-of- network) Therapeutic Alternatives GET HELP Explore opportunities to switch to lower cost drugs in the same class Learn More about Drugs Evidence-based information from Consumer $4 Generics (not shown) Reports about best buys, safety & quality See available $4/$10 generics Instructions Medication Lists Links to instructions, frequently asked Track medications for yourself & others questions and demos Online Help Search Help and access online Access anytime from your | RxBenefits | SAW support smartphone or computer browser • At your physician’s office • At home • At work 8
Mobile ile Apps: Expre ress ss Scr cripts pts Manage ge Prescri scriptio ptions ns For Members-on-the-Go • Register your account from their mobile • Check Express Scripts Pharmacy order device. shipping information. • Transfer eligible maintenance • Locate a nearby pharmacy using GPS medications to Express Scripts Pharmacy. technology. • Select and schedule prescription refills • Access DrugDigest database for and enroll eligible prescriptions in auto information, uses, possible side refills. effects, etc. • Set a reminder for medication doses. | RxBenefits | SAW 9
Who Is Who? ? RxBenefits, RxAssure & Express Scripts…… • • Rx RxBenefit fits Exp Express Scr Scripts – – Pharmacy Benefits Administrator Pharmacy Benefit Manager • – RxAss Rx Assure (through RxBenefits) Specialty pharmacy, Accredo – – Member Services: Pharmacy Help Desk • Denied claims – Back-up customer service • Copay inquires – Mail Order pharmacy • Plan questions • Customer service issues/questions • Locate a pharmacy • Pricing questions • Included/excluded | RxBenefits | SAW medication 10
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