Prescription Plan
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Early Retiree and participants who elect Kaiser Senior Advantage receive their prescription drug benefit through Kaiser Permanente. A brief description of the prescription drug benefit is described in the Kaiser BenefitTab.
PacifiCare Secure Horizons and Early Retirees who elect PacifiCare receive their prescription drug benefit through PacifiCare. A brief description is provided below.
Participants who elect Medicare Supplement or Premium Reimbursement receive their prescription drug benefit through Prescription Solutions plan called Mandatory Generic Prescription Drug Plan. The Mandatory Generic Prescription Drug Plan is designed to help you meet the cost of prescription drugs prescribed by your doctor, for you or your eligible spouse, for the treatment of illness or injury. The pharmacist will dispense a generic drug substitute whenever it is available. If you choose to obtain a brand name drug instead of a generic, you may do so, but it will result in greater expense for you.
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Walk-in Pharmacy Benefits
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| Category |
Your Copay |
Generic - 30 day supply |
$0 |
| Generic ( 100 day supply - maintenance) |
$0 |
| Brand-name - 30 day supply (when generic not available) |
$10 |
| Brand-name (100 day supply- maintenance) |
$20 |
| Brand-name - 30 day supply (when generic available) |
$10 + ingredient cost |
| Brand-name (100 day supply - maintenance) |
$20 + ingredient cost |
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Mail Service Pharmacy Benefits for Maintenance Drugs
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| Category |
Your Copay |
| Generic - 100 day supply |
$0 |
| Brand-name 100 day supply (when generic not available) |
$20 |
| Brand-name 100 day supply (when generic available) |
$20 + ingredient cost |
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Non-Network Pharmacy Benefits
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You must file a claim to be reimbursed
for your drugs within 15 months of the purchase.
This option is intended for emergencies or when
travelling only. Reimbursement is limited by the
Plan's average costs for prescriptions; you will pay for amounts over the limits in addition to the copay.
| Category |
Your Copay |
| Generic - 30 day supply |
$0 |
| Brand-name 30 day supply (when no generic available) |
$10 |
| Brand-name 30 day supply (when generic available) |
$10 + ingredient cost |
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Network Pharmacy Chains
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Albertsons, Big "A" Drug Stores, Costco, Gemmel Pharmacy, Horton and Converse, K-Mart Pharmacies, Longs, Medicine Shoppe, Pavilions Pharmacies, Raley's Super Stores, Ralphs, Rite Aid, Safeway Pharmacy, Savemart Supermarkets, Sav-On Drugs, Scolari's Food & Drug, Shopko Stores, Target, Vans/ Pavilions Pharmacies, Walgreens
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Limitations
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Certain limitations apply to the following covered benefits: smoking deterrents, morning after pills & kits, and drugs to treat erectile dysfunction. Amendment 11 to the Retiree Health Plan Summary Plan Description details these limitations.
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Additional Information
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Prescription Solutions
Customer Service Phone Number: 1-800-797-9791
Website: www.rxsolutions.com
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