Empire Plan prescription drug programs to be administered by UnitedHealthcare and Medco
Effective Jan. 1, 2008, UUP members in the Empire Plan are able to use a new prescription plan. UnitedHealthcare will insure and administer The Empire Plan Prescription Drug Program and partner with Medco Health Solutions for retail pharmacy network and mail pharmacy services.
This change does not affect members who are enrolled in an HMO for 2008.
• There will be no change in benefit design. That means co-payments for all covered prescriptions for generic, preferred brand-name and non-preferred brand-name drugs will not change.
• The majority of the Empire Plan’s current network pharmacies will participate in The Empire Plan/Medco network, including most retail chain pharmacies.
• Same financial advantages to use the mail-order program.
• Same mandatory generic substitution requirements.
• The current Empire Plan Benefit Card will continue to provide access to all benefit needs.
• A seamless transition from Caremark to Medco Health Solutions.
• Prescriptions for compound drugs and controlled substances (Rx number begins with “Câ€) will require a new prescription.
• Mail-order prescriptions will be filled at Medco’s Cincinnati facility.
• Postage-paid addressed envelopes for the mail service pharmacy (reflecting the new address) are available.
• Medco will receive an “open refill†file from Caremark that will be loaded to the system, providing enrollees access to the prescriptions that were previously on file with Caremark. This will include open refills at the retail level.
Pharmacy Network
• Empire Plan enrollees will have access to an extensive and comparable pharmacy network including all major chains.
• Members should call Medco Health Solutions at (877) 769-7447 to locate a participating provider in their area.
Preferred Drug List (PDL)
• Enrollees may experience minor changes to the PDL.
• Enrollees will be notified by mail if they have filled a prescription within the last six months that will no longer have preferred status.
• The list of prior authorization drugs, and drugs with quantity limitations, remains the same.
• The PDL is reviewed and updated annually.
• A copy of the PDL was included in a special Empire Plan Report; it is also available on the Department of Civil Service Web site at www.cs.state.ny.us.
Contacting Medco Health
• Continue to call (877) 7-NYSHIP and select the dedicated prompt for prescription drug questions.
• The dedicated prescription drug customer service center will be open Monday through Friday from 7 a.m. to 10 p.m.; Saturday from 9 a.m. to 9 p.m.; and Sunday from 9 a.m. to 5:30 p.m.
• A pharmacist will be available 24 hours a day, seven days a week.
• The Interactive Voice Response system will be available 24 hours a day, providing enrollees access to general information such as refill status, new prescription status, order placement, etc.
• The Department of Civil Service Web site will offer a secure member Web site, which will provide enrollees with access to benefits, pharmacy locations, mail-order claims status, preferred drug listing and other helpful information.
Visiting the pharmacy
Please reference the information listed below the first time you use an Empire Plan/Medco participating retail pharmacy to fill your prescription:
• UnitedHealthcare administers the Empire Plan Prescription Drug Program
• Rx Group: UH0712959
• Bank Identification Number: 610014.
If you have any questions, please don’t hesitate to call the UUP Benefit Trust Fund at (800) 887-3863.
— Doreen Bango, Manager of Benefits and Services