Prescription Drug Plan - Administered by Pharmacare

Prior to January 1, 2008 Benefits & Eligibility administered by A&I Benefit Plan Administrators, Inc.

Plan Overview

A&I administers the Select and Choice Medical Plans prior to January 1, 2008. We have also provided overviews of the Rx, Dental and Vision Plans as well. You can view highlights of these Plans by clicking on the tabs below.

Prescription Drug Plan

The Select and Choice PPO plans offer two ways to save money on prescription drugs - through retail pharmacies and the mail order service. Both are administered by PharmaCare Management Service, Inc. . Click on the tabs below for details.

Retail Pharmacy Benefits

You can get your prescription filled at any pharmacy participating in the PharmaCare pharmacy network. The PharmaCare network includes many independent pharmacies and most major pharmacy chains.

The plan pays covered prescriptions at 100% after you pay the applicable co-payment. Your co-payment will depend on the type of prescription drug you receive - generic, preferred brand name or non-preferred brand name prescription drugs. What are generic, preferred and non-preferred brand name drugs? Click here for a description.

Prescription Drugs	Plan 1-Select Plan	Plan 2 Choice Plan PPO (Managed Healthcare Northwest Providers)	Plan 2-Choice Plan PPO (Any Provider)
Managed Pharmacy	Administered by PharmaCare	Administered by PharmaCare	Administered by PharmaCare
Retail 30-Day Supply	Prescription drug purchases at a participating pharmacy. Generic: 100 % after $12 copayment Preferred Brand: 20% coinsurance ($20 miniumum; $70 maximum) Non-Preferred Brand: 35% coinsurance ($40 minimum; $90 maximum)	Prescription drug purchases at a participating pharmacy. Generic: 100 % after $12 copayment Preferred Brand: 20% coinsurance ($20 miniumum; $70 maximum) Non-Preferred Brand: 35% coinsurance ($40 minimum; $90 maximum)	If you use a non‑participating pharmacy, you will pay 100% of the prescription cost at the time of purchase. You must then file a paper claim form along with the original prescription receipt to PharmaCare for covered medications. The out‑of‑network pharmacy cost will be paid at the same amounts as an in‑network pharmacy. The plan participant pays the difference.
Prescription Drug Annual Out-of-Pocket Maximum (Applies to Retail and Mail Order Drugs)	$2,000 per individual (combined In-Network and Out-of-Network)	$2,000 per individual (combined In-Network and Out-of-Network)	$2,000 per individual (combined In-Network and Out-of-Network)

Mandatory Generic Requirement: All prescriptions filled under the retail or mail order prescription drug program will be automatically filled with the generic version of medication (if one is available). Otherwise, you will be charged the difference in the price between the brand-name and generic version of that medication, pus the generic copay.

THE LISTING OF PREFERRED BRAND DRUGS CAN BE OBTAINED FROM THE HUMAN RESOURCE DEPARTMENT OR YOU MAY REQUEST THE LIST FROM PHARMACARE.

Important note: You will pay the non-preferred drug co-payment if a generic or preferred brand name drug is not available.