New Annual Deductible for Injectible & Chemotherapy Medications
Effective January 1, 2006, there will be an annual deductible of $100 per person for Injectable & Chemotherapy medications. This deductible is independent of any other deductibles.
Additional changes that have already taken effect:
Effective July 1, 2005, the PICA Prescription Drug Program will only cover two (2) categories of drugs: Injectables and Chemotherapy.
New Co-payments for Injectible & Chemotherapy Medications
Retail Pharmacy (up to 30-day supply)
- $10 for generic medications
- $25 for preferred brand name (formulary) medications
- $45 for non-preferred brand name (non-formulary) medications*
Mail Order Pharmacy (up to 90-day supply)
- $20 for generic medications
- $50 for preferred brand name (formulary) medications
- $90 for non-preferred brand name (non-formulary) medications*
*If you choose a non-preferred brand name medication that has a generic equivalent, you will be charged the difference in cost between the non-preferred brand name drug and the generic drug plus the non-preferred co-pay.
Effective July 1, 2005, Coverage for Psychotropic and Asthma medications returned to the PBA Funds Office through Caremark. If you have a prescription refill with NPA/Express for either a Psychotropic or Asthma medication, you will need a new prescription after July 1, 2005 to file with Caremark. Your Caremark coverage does not require mandatory mail order for either Psychotropic or Asthma medications.
ACTIVE MEMBERS:
Please note, both Psychotropic and Asthma medications will be subject to the standard Caremark co-payments as follows:
RETIRED MEMBERS (Non Medicare):
Please note, both Psychotropic and Asthma medications will be subject to the standard Caremark co-payments as follows:
*Co-payments will not exceed Caremark's discounted drug cost.
If you have any questions regarding your PICA prescriptions, please contact NPA/Express Scripts Customer Service at (800) 467-2006. For questions regarding your Caremark prescriptions, please contact the PBA Funds Office at (212) 349-7560 or Caremark Customer Service at (877) 722-7911.