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.
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- 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:
- Annual : $10,000
- Lifetime : (Effective March 1, 2012) No limit
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.
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.