printable versionInformation about drug coverage for retirees needs clarification
The Sept. 22 issue of the Retiree Newsletter contains information about prescription drug coverage that requires clarification.
According to the Benefits Office, beginning in 2007, prescription drug coverage for retirees becomes part of a retiree's chosen medical plan and will no longer be a separate program with Express Scripts.
My questions are these:
1. Retirees now filling their prescriptions through Express Scripts, the Arizona-based formulary, receive a 90-day supply at considerable savings. Will they continue to receive the same supply when the coverage is provided by their medical plan or will they get the customary 30-day supply provided by pharmacies?
2. Will any pharmacy be allowed to fill prescriptions or just pharmacies designated by the health plans?
3. Will the co-pay for prescriptions be the same or higher under the new arrangement?
The Benefits Office must also clarify this statement:
"With this change, you will no longer be able to use your current Express Scripts card. (Note: Blue Shield and Health Net both contract with Express Scripts to administer their mail order drug program, but you will not receive a separate prescription ID card or be able to use your current card)."
If not, what ID do retirees present to get their prescriptions filled?
For several years, the Benefits Office had worked with an advisory committee made up of faculty and staff retirees. I served on that committee. Each year before Open Enrollment we reviewed drafts of communications to retirees to make sure the information was clear, accurate and understandable. For whatever reason, there was no meeting this year. The Benefits Office may need to re-activate such a committee.
Spyros Andreopoulos
Stanford
BenefitSU responds:The newsletter Spyros Andreopoulos refers to was only intended as an overview. A full package of information was mailed to retirees two weeks ago and included detailed information on prescription drugs and how the new arrangement will work.
When obtaining medical care one must always use a network provider, including network pharmacies, in order to best utilize the plan's benefits. Most medical plans (with the exception of Kaiser) include a wide network of pharmacies, just as Express Scripts does.
The co-pays for brand-name and nonformulary drugs did go up, but it was the result of increased usage and the cost of those drugs, not the change from Express Scripts to the medical plans.
We encourage anyone with questions on prescription drugs, pharmacy networks or their medical plans to attend one of the Benefits Fairs. Benefits Fairs and flu shots are scheduled from 10 a.m. to 3 p.m. Nov. 7-8 in the Oak Lounge of Tresidder Union, Nov. 9 in Fairchild Auditorium and Nov. 10 in Panofsky Auditorium at the Stanford Linear Accelerator Center. In addition to the opportunity to talk with health plan representatives, there will be a special presentation for retirees that reviews their 2007 benefits and how they work. For a more detailed Benefits Fairs schedule, visit the web at http://benefitsu.stanford.edu/ and click on the link beneath "Benefit Fairs and What's New."