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Benefit highlights: home delivery plan

When to Use
The most efficient way to fill prescriptions that you take for long-term or chronic conditions is through the Home Delivery Pharmacy Service.

Days Supply
Through the Home Delivery Pharmacy Service, you can purchase up to a 90-day supply of most prescription medications. There may be limitations on some prescriptions, such as controlled medications, subject to state and federal dispensing limitations.

Co-payment
Different co-payments may apply for certain medications.

Tier 1:
  • Your co-payment is $25.00.

Tier 2:
  • Your co-payment is $62.00.

Tier 3:
  • Your co-payment is $125.00.

If the patient requests a brand-name medication when a generic equivalent is available, your co-payment will be equal to the generic co-payment plus the difference in price between the brand-name medication and its generic equivalent. This difference in price is charged only on certain medications.

Click here to determine pricing and coverage for a specific medication.
Coordination of Benefits
Coordination of Benefits is the process in which two or more health insurers cover the same person(s) but limit the total benefit payable for a claim to an amount not exceeding the total cost of the claim.

If Medco is your secondary benefit, primary claims submitted by the retail pharmacy or primary paper claims submitted by you will not be covered. If you have sent the prescriptions through mail order and Medco is your secondary benefit, you will be contacted to verify your coverage.
You may submit a paper claim to be considered for reimbursement under your secondary coverage.

The Coordination of Benefit applies to:
  • Your member-submitted paper claims only.

For further information on Coordination of Benefits or for an explanation on the reimbursement of a claim, please call the Member Service phone number on the back of your card.

This information is intended to serve as a general overview of your plan sponsor's prescription benefit program. Please note that the terms of your prescription benefit are subject to change. Please consult your plan sponsor for complete information.

 
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