TeamCare Express Scripts benefit

BrownChoice

Well-Known Member
Western Region Healthcare

So, what is the deal. Is it after the 2nd fill of maintenance meds its only %50 covered ? Or does it matter?

Ive gotten a poster saying it was changed to require a $5 co pay retail generic or brand with no generic available and no co pay if filled mail order.

Now another one I've gotten states the 1st above?!

By the way are ANY medication taken on regular basis day to day considered a maintenance med or.....
 

ManInBrown

Well-Known Member
No. If you fill a maintenance medication more then twice at a retail pharmacy you are responsible to pay for 50%. You have to fill maintenance meds thru mail order. Which I'm not happy about. $5.00 co-pay for generic. Who knows how much brand name will be, or if it's even an option? Where before it was generic for free, and $5.00 for brand name, and you could fill at retail location. Now everyone has to get all new scripts with meds written out in 90 day supplies. 90 day is required for mail order. They won't accept any other quantity prescriptions. Another hassle
 
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UpstateNYUPSer(Ret)

Well-Known Member
No. If you fill a maintenance medication more then twice at a retail pharmacy you are responsible to pay for 50%. You have to fill maintenance meds thru mail order. Which I'm not happy about. $5.00 co-pay for generic. Who knows how much brand name will be, or if it's even an option? Where before it was generic for free. And $5.00 for brand name.

Why don't you ask bbsam how much he will have to pay for his wife's RA medicine each month, which is not covered? (I'll give you a hint---the medicine is called Enbril, there is no generic available and it costs $2,500/month) Perhaps that would put things in to perspective for you.
 

ManInBrown

Well-Known Member
Why don't you ask bbsam how much he will have to pay for his wife's RA medicine each month, which is not covered? (I'll give you a hint---the medicine is called Enbril, there is no generic available and it costs $2,500/month) Perhaps that would put things in to perspective for you.

Obviously there are millions and millions of people in a worse spot. So does that mean I should be happy about the changes for the worse? Does that make it OK? JUst because others have it worse? No it doesn't. Theres a reason we get the pay and bennies we do. And I'm not happy about the changes. Thats my opinion and I'm entitled to it.
 

UpstateNYUPSer(Ret)

Well-Known Member
Obviously there are millions and millions of people in a worse spot. So does that mean I should be happy about the changes for the worse? Does that make it OK? JUst because others have it worse? No it doesn't. Theres a reason we get the pay and bennies we do. And I'm not happy about the changes. Thats my opinion and I'm entitled to it.

I am glad you chose the word "entitled" as it perfectly describes many of those in union shops.

You are not "entitled" to anything.
 

Indecisi0n

Well-Known Member
Do you guys read at all?

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Wally

BrownCafe Innovator & King of Puns
I use Express and love it. My doctor fax's them any changes.

By the way, doctors always have samples they can give you for the first week for many meds until the order arrives. Doesn't hurt to ask.
 

UpstateNYUPSer(Ret)

Well-Known Member
Maybe I read it wrong, but I believe the man is entitled to his opinion.

Of course he is. We all are. Opinions are normally based upon one's personal experience and I have found that most union people have a false sense of entitlement, especially when it comes to their benefits.
 

kimism

New Member
My concern on the 2 fills of maintenance meds at a pharmacy is that we are constantly changing my meds. So this has me really concerned. My main question is if a maintenance med dosage is changed does this start the 2 fills over again? Most of my meds are psych & pain meds therefore there is no way to get a 90 day prescription.

I did some preliminary calls this past week but no one could really answer anything. I was actually told by Blue Cross that the contract was not yet final. For me the prescriptions benefit is way better but the psych benefit sucks donkey balls. 30 visits a year sucks as I see a therapist 2x's a week & a psychologist bi-weekly. Needless to say I will run through those 30 visits in no time.
 

BrownChoice

Well-Known Member
So is it considered a maintenance med only if your doctor writes for 90 day supplies?

_and obviously schedule 2 medications are 30 days only. Yet are taken on a daily basis for a lot of chronic pain patients.

So... Anyone know , as ive called and got no answer from EXPRESS
 

ManInBrown

Well-Known Member
So is it considered a maintenance med only if your doctor writes for 90 day supplies?

_and obviously schedule 2 medications are 30 days only. Yet are taken on a daily basis for a lot of chronic pain patients.

So... Anyone know , as ive called and got no answer from EXPRESS

No. To fill the script thru mail order it has to be written in 90 day refills. Mail order will not fill 30 at a time. Thus the reason for needing the script to be written for 90 at a time. Maintenance meds are a regular medication you take all the time. Usually daily
 

DriveInDriveOut

Inordinately Right
So is it considered a maintenance med only if your doctor writes for 90 day supplies?

_and obviously schedule 2 medications are 30 days only. Yet are taken on a daily basis for a lot of chronic pain patients.

So... Anyone know , as ive called and got no answer from EXPRESS
Adderall is schedule 2, and under the old UPS medco/express scripts, I could fill it monthly at walgreens without the 50% maintenance mail order requirement.

It might depend on your state, but I'm pretty sure schedule 2 drugs can't be written as 90 day prescriptions. Your doc might write you post dated prescriptions so you don't have to come back every month(mine does), but you'll still need to fill them one at a time, and won't be charged the 50% maintenance medication premium for picking them up without mail order. That's how it's worked for me at least, the 50% maintenance medication local pick up charge has been in place here for a while now.
 
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BrownChoice

Well-Known Member
Ok, that helps a lot more because frankly yes i can see mail ordering a blood pressure medication or things like that. But with psychoactive medications that are still taken daily, mail order seems to be of no benefit and really a huge hassle.
 

DriveInDriveOut

Inordinately Right
Ok, that helps a lot more because frankly yes i can see mail ordering a blood pressure medication or things like that. But with psychoactive medications that are still taken daily, mail order seems to be of no benefit and really a huge hassle.
I totally agree. The mail order is kind of a pain in the butt, especially since it's 2014 and who the hell has a fax machine anymore to send in these forms.

But since our union is running our healthcare now, it's in all of our best interest to make prescriptions cheaper, and cutting out the middle man (pharmacists) helps them do that. Hopefully with health care off the table now we'll have more power to negotiate next contract... maybe I'm just trying to find a silver lining in a thunderstorm, only time will tell.
 

OPTION3

Well-Known Member
Of course he is. We all are. Opinions are normally based upon one's personal experience and I have found that most union people have a false sense of entitlement, especially when it comes to their benefits.
In my experience, I have found that most NON union people spend more time UNDER the desk without a UNION steward than across it WITH a UNION steward
 
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