A Resource Guide for Maximizing Prescription Drug Benefits

The start of the new year is a good time to remind your employees of the tools available to help them understand and maximize pharmacy benefits.

NRECA offers the following resources that explain enhancements of the new plans, and highlights ways to save money and make the best choices.

2017 Prescription Drug Price Shopping Guide. Three fliers—(one for each of the new plans, 3-Tier Copayment, 3-Tier Coinsurance and 2-Tier Coinsurance)—highlight plan designs, break down the costs of the different types of drugs (e.g. generic, preferred) and gives examples of costs per type. (Applies to preferred provider organization (PPO) plans)

Performance Drug List. New for 2017, this list replaces the Preferred Drug List. This performance drug list is more comprehensive and convenient, containing both preferred brand drugs and generic drugs covered under the prescription drug plan. (Applies to HDHP and 3-tier traditional PPO plans)

HDHP Preventive Drug Coverage Option Chart. A flow chart aids in determining the cost share for prescriptions when the co-op’s HDHP includes preventive drug coverage. (Applies to HDHPs)

NRECA Exclusive Choice (list). A list featuring Exclusive Choice retail pharmacies nationwide, offering plan participants greater savings on their prescription drugs. (Applies to all NRECA prescription drug plans)

Medications Requiring Prior Authorization. A list of prescription drugs no longer covered under the prescription drug benefit without a prior authorization for medical necessity. (Applies to traditional plans including the Simple Plan and HDHPs)

List of Specialty Drugs Excluded From Medical Plan. A list of specialty drugs that are designated for coverage under the prescription drug benefit plan rather than the NRECA Medical Plan. Participants should work with their care providers to ensure the drug is being filled in coordination with the CVS/specialty team (this team can be reached at 888.265.7790). (Applies to traditional plans including the Simple Plan and HDHPs)

Check Drug Cost and Coverage tool (under Manage Your Prescriptions). Lists the price of a medication and whether it’s covered under the participant’s plan. Lower-cost options are listed, if available.