Your prescription drug benefits are administered by Caremark. As a HealthSelect participant, you have a separate HealthSelect pharmacy ID card issued by Caremark.
For questions about your prescription drug benefits or claims, or to order a new pharmacy ID card, contact Caremark at (888) 886-8490 or visit Caremark's website.
For prescriptions prior to September 1, 2008, Medco was the prescription drug administrator.
The specialty pharmacy program is provided through Triessent®. This program offers members who have a complex medical condition, requiring specialty medications, convenient delivery of those covered medications as well as coverage coordination and support. You can contact Triessent at (888) 216-6710, Monday through Friday, 7 a.m. to 6 p.m. Central Time.
Benefits Summary Effective September 1, 2009
Copayment amounts assume that the $50 Plan Year Deductible has been satisfied.
| Drug Category | *Retail |
*Retail Maintenance |
Mail-Order |
| Tier 1 | $10 |
$15 |
$30 |
| Tier 2 | $25 |
$35 |
$75 |
| Tier 3 | $40 |
$55 |
$120 |
| *Participating pharmacies. For more information on coverage for non-participating pharmacies, refer to your HealthSelect Benefits Book. | |||
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