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Home | Benefits Coverage | 1400 Hour Employees | Prescription Drugs

Prescription Drugs

Participants in the JBT Medical PPO plan receive prescription drug coverage through JBT’s Pharmacy Benefits Manager, CVS Caremark.

This section covers:

For a complete description of the JBT Medical PPO plan’s prescription drug benefits, refer to the “JBT Prescription Drug Coverage” section of the Summary Plan Description (1.1 MB PDF).

Note: Participants in Kaiser or PacifiCare receive prescription drug coverage through their HMO. Information regarding HMO prescription drug coverage is not on this page; however, you can find it in each HMO’s Evidence of Coverage booklet.

How the JBT Prescription Drug Program Works

You can fill your prescriptions as follows:

  • You can get a 30-day supply of prescription drugs at a CVS Caremark participating retail pharmacy
  • You can get a 90-day supply of maintenance prescription drugs through the mail, using the CVS Caremark mail-order program

The amount you pay depends on whether the prescription is designated as a generic drug, preferred brand-name drug or non-preferred drug through the CVS Caremark drug list. In addition, when you use the mail-order program, you pay less out of your pocket because the copayment applies to a 90-day supply as compared to the 30-day supply covered at the retail pharmacy.

Here’s a summary of what you pay:

Drug Type

Participating Retail Pharmacy
(up to 30-day supply)

Mail-Order
(up to 90-day supply)

Generic

$10 copay

$20 copay

Preferred Brand-Name*

$20 copay

$40 copay

Non-Preferred*

$35 copay

$70 copay

*

If you receive a preferred brand-name or non-preferred drug when a generic equivalent exists, you pay the applicable higher copayment plus the difference in cost between the two drugs.

Contact CVS Caremark at 1-888-685-7752 to request a copy of the current drug list.

Using a Participating Retail Pharmacy

You need to fill your prescriptions through a participating CVS Caremark pharmacy. The CVS Caremark network includes over 64,000 pharmacies nationwide—most major chains and many independent pharmacies are contracted through CVS Caremark.

You can find a participating pharmacy online through the CVS Caremark website (www.caremark.com). Once you register on Caremark.com, you can search for pharmacies close to your work or home. You can also find a participating pharmacy by calling CVS Caremark at 1-888-685-7752.

You must use your CVS Caremark ID card when you purchase your drugs at a retail pharmacy. In most cases, drugs purchased without using your prescription benefit ID card are not covered—you will pay the full cost. If you’ve misplaced your prescription benefit ID card, contact CVS Caremark at 1-888-685-7752 or the JBT Administrative Office at 1-800-JBT-HELP (1-800-528-4357) to request a new card. You can also request a new card through the CVS Caremark website.

Using the Mail-Order Drug Program

Participants who need maintenance drugs can save time and money by using the mail-order drug program. You can order up to a 90-day supply of your maintenance drugs through mail-order.

When you received your prescription drug ID card from CVS Caremark, your package included a supply of mail-order forms and return envelopes. To fill your maintenance drug prescription by mail, simply complete and return the form, along with your doctor’s prescription and applicable copayment, in the self-addressed envelope. For future orders, you will receive a computer-generated order form and pre-addressed envelope with each prescription mailed to you. The form is filled in with your information, so you will not need to complete the form every time you submit a mail-order prescription.

If you need to request more forms and return envelopes, contact CVS Caremark at 1-888-685-7752.

Reduced Copayments for Participants with Chronic Conditions

JBT contracts with Healthways, a chronic disease management company, to provide patient support and lifestyle coaching for members who have chronic health conditions, including:

  • Diabetes
  • Congestive heart failure
  • Coronary heart disease
  • Chronic obstructive pulmonary disease (COPD)
  • Asthma
  • Oncology
  • Atrial Fibrillation
  • Hepatitis C
  • Osteoarthritis
  • Inflammatory Bowel Disease

If you or a covered dependent is diagnosed and under treatment for one of these chronic conditions and you agree to participate in the Chronic Disease Management (CDM) program, you may be eligible for the following reduced prescription drug copayments:

Copayment without Participation in CDM

Copayment with Participation in CDM

Retail Pharmacy

Generic

$10

$0

Preferred Brand-Name

$20

$10

Non-Preferred

$35

$25

Mail-Order

Generic

$20

$0

Preferred Brand-Name

$40

$20

Non-Preferred

$70

$50

To be eligible for reduced copayments, you simply need to participate in two phone “care” calls with a Healthways nurse during a 12-month period. Your copay reduction will begin two months after you complete your second phone call with Healthways.

The JBT Administrative Office will notify you when you meet the participation criteria and will advise you of the beginning and end dates of the copayment reduction period.

For more information about the Chronic Disease Management program, refer to the Health Matters section of this website.

Pre-Authorization

Because of the cost, possible side effects and potential for abuse, some drugs are not covered unless their use has been pre-authorized by CVS Caremark. To apply for authorization, your doctor must contact Caremark at 1-800-294-5979. The list of drugs requiring pre-authorization may change from time-to-time. You can contact CVS Caremark customer service at 1-888-685-7752 to find out if a drug requires pre-authorization. You can also use the "Check Drug cost" tool available through the CVS Caremark website, which will indicate whether a drug is subject to pre-authorization.

Using the CVS Caremark Website

You can use the CVS Caremark website (www.caremark.com) for a wide range of services. You can fill or refill your prescriptions (retail and mail-order), check your prescription benefits coverage, find a participating retail pharmacy, review your prescription history, request a replacement pharmacy benefits ID card, download forms and review the CVS Caremark drug list.

To take advantage of these features, you will need to register through the CVS Caremark website. To register, you’ll need to enter information from your prescription benefit ID card and personal information, including your name, date of birth and zip code.

If you have questions about registering and using the CVS Caremark website, contact CVS Caremark at 1-888-685-7752.

Frequently Asked Questions

Save money with generic drugs. Learn more »

Customer Service

CVS Caremark
1-888-685-7752
www.caremark.com

Documents

JBT 1400 Hour Summary Plan Description (1.1 MB PDF)

JBT 1400 Hour SMM (32 KB PDF)

PacifiCare Prescription Drug Evidence of Coverage (112 KB PDF)

Kaiser Permanente Evidence of Coverage (496 KB PDF)

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The information on this website is intended only to provide highlights of the benefits available under the Joint Benefit Trust. Complete information about the Plan is contained in the governing Plan documents and any applicable insurance contracts. In the event of any inconsistency between the information on this website and the official Plan documents, the terms of the official Plan documents will govern. The Joint Benefit Trust reserves the right to amend, modify, or terminate all or part of the Plan at any time.

Page modified on 12/20/10 10:59 AM