July 1, 2014 - June 30, 2015 Pharmacy Benefits
View full plan details and changes to copay amounts here
Duquesne University and CVS/Caremark are working together to find better ways to effectively manage prescription drug costs, which are increasing faster than any other health care expense.
- Prescription medication coverage provided by CVS/Caremark is included with Cigna OAP and UPMC EPO plans.
- Plan H members will use their Cigna medical card for prescription drug coverage, as medical and prescription expenses are combined to meet the deductible. Visit www.mycigna.com for details.
Beginning July 1, 2012, maintenance prescriptions (drugs prescribed to treat an ongoing medical condition) must be filled for a 90 day supply in one of the following three ways for Cigna OAP and UPMC EPO participants:
- Duquesne University's Center for Pharmacy Services (our Pharmacy on the Hill) via campus delivery or walk in services. If you choose to use this service for maintenance drugs, please follow the directions to complete the enrollment form. The Center for Pharmacy Services can be reached at 412.246.0963.
- CVS Caremark mail order services - 1.877.347.7444
- The CVS retail pharmacy location of your choice
Cigna Plan H participants should contact Cigna at 1-800-244-6224 to enroll in mail service for maintenance drugs.
Acid Reflux and Non-Sedating Antihistamines
As of July 1, 2012, acid reflux and non-sedating antihistamines will no longer be covered under the prescription drug plan. Many of these brand name drugs are now available over the counter. Talk to your doctor to determine the best over the counter treatment for you. If you fall into one of the below categories, your doctor can complete a prior authorization form to request that you remain eligible to receive your acid reflux treatment through the pharmacy benefit:
CVS/Caremark’s Step Therapy program, based on FDA guidelines, clinical evidence and research, is an effective way to provide safe, high quality and affordable options, particularly if you are taking a regular prescription medications. This program requires you try one medication first to see if it is effective before "stepping" to another medication.
- The first step is usually a preferred generic medication.
- If the first step medication is not effective for you, then you may be able to "step" to the next medication.
If your physician or provider believes that the "first step" medication will be ineffective or may be harmful, a prior authorization request can be submitted to CVS/Caremark for review.
Safe And Effective Generics
The Step Therapy program includes the three categories of commonly prescribed medications below that have clinically safe and effective generic alternatives and the potential for cost savings.
- If you are currently taking one of these drugs please contact your physician.
- Together, you can discuss what medication options are best for you.
- Your physician will be able to determine whether to write a new prescription or to submit a step therapy exception request for your current medication.
STEP THERAPY PROGRAM DRUGS
Specialty drugs are prescription medications that require special handling, administration or monitoring. These drugs are used to treat complex, chronic and often costly conditions.
CVS/Caremark Specialty Pharmacy is included as part of your prescription benefit program. This valuable program provides access to specialty medications used to treat cancer, growth hormone deficiency, hemophilia, hepatitis C, immune deficiency, multiple sclerosis, and rheumatoid arthritis. Whether they’re administered by a healthcare professional, self-injected, or taken by mouth, specialty medications require an enhanced level of service.
The copay for specialty pharmacy prescriptions is 20% employee copayment with a $50 minimum and a $100 maximum per prescription.
Specialty Pharmacy Services and Support
- Convenient express mail delivery to your home, physician’s office or your local retail pharmacy
- Regular contact and support from a team experienced specialty pharmacists and other clinical care experts
- Education on how to take medications correctly, proper medication storage and handling, and preparing for emergencies
- Troubleshooting side effects
- Communication of treatment issues to your health care provider
- Coordination of care with third parties, as needed
- 24/7 phone access at 1.800.237.2767
How to Save on Prescription Drugs
- Request a comparable generic version of your prescription
- Order maintenance medications through the mail order program
- Visit the Center for Pharmacy Care for zero dollar copayments on prescriptions for cholesterol, depression, chronic pain management, asthma, and diabetes
- Set up a healthcare flexible spending account to use pretax dollars to pay for your prescriptions. Remember that you can list your Discovery Benefits debit card as your payment method on your mail order profile.
- Ask your doctor if a prescription drug is really necessary. There are over-the-counter medications that often work as well as their prescription counterparts. Some of these remedies such as Claritin for allergies or Prilosec for heartburn were once prescription only.