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RETIREE FUND
Prescription Drug Plan
The Retiree Health and Welfare Fund of the Patrolmen's Benevolent
Association provides a mandatory generic benefit for prescription
drugs for all retired members and their eligible dependents through
the use of the PBA/CAREMARK Prescription Drug Program. The
PBA Prescription Drug Program utilizes a formulary tier system
and contains a mail order provision.
Limitations on Coverage
Co-payments:
-
Generic - Greater of $20.00 or 25%, not to exceed CAREMARK
discounted cost of drug
-
Formulary - Greater of $40.00 or 25%, not to exceed CAREMARK
discounted cost of drug
-
Non-Formulary - Member pays 100% of CAREMARK discounted cost
of drug
The following maximums apply to your Prescription Drug Benefit:
The program covers most medications which require a prescription
by either state or federal law, have been approved by the Food and
Drug Administration (FDA), for use in connection with the treatment
of the diagnosis for which the drug is being dispensed, are prescribed
by a licensed practitioner and dispensed by a licensed pharmacist.
When using a participating pharmacy, no claim forms are necessary.
Present the PBA/CAREMARK plastic identification card and the prescription
to your pharmacist. The pharmacist will dispense the prescription
and CAREMARK will reimburse the pharmacy directly. The member will
pay only the applicable co-payment. If in doubt as to whether or
not the pharmacy is participating in our program, the member may
obtain the name and location of participating pharmacies by contacting
CAREMARK at 1 (877) 722-7911.
Arrangements For Continued
Use Of A Particular Medication
A number of medications are considered to be maintenance drugs
and are prescribed for such conditions as hypertension, heart disease,
diabetes, etc. When prescribed by a physician, it is usually for
a prolonged period of time. To eliminate the need to repeatedly
visit a pharmacy each month, CAREMARK has a Mail Service Program.
The Mail Service Program will provide the member with a three (3)
month supply of a prescribed medication, and the prescription will
be mailed directly to the member's home. To use this program, the
member should refer to their CAREMARK Prescription Drug Benefit
Program Booklet or call CAREMARK at 1 (877) 722-7911 or at www.caremark.com.
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