PRESCRIPTION COVERAGE – Pharmacare
Effective July 1, 2006

Employees who enroll in the school system’s medical plan also receive prescription coverage through Pharmacare. The Pharmacare prescription card is recognized by almost every major pharmacy and many small neighborhood locations, too. Your co-pay is $8 for a generic drug, $20 for a preferred brand name drug, and $35 for non-preferred drugs for a 30-day supply purchased at a retail pharmacy. The copayments are $16/$40/$60 for a 90-day mail order supply.

The preferred formulary program administered by Pharmacare is a list of preferred drugs (including brand name and generics) that meet a patient’s needs, usually at a lower cost than non-preferred drugs. Drugs are included on a formulary only after a team of pharmacists and physicians evaluate their effectiveness and cost relative to available alternatives. The team of pharmacists and physicians meets quarterly to review new and existing drugs. A decision about a drug’s status (preferred or non-preferred) is based on:

• whether or not the drug works to treat the illness or medical condition
• how appropriate the drug is for treatment of a particular medical condition
• safety of the drug
• standards of medical practice
• cost of the drug

Additional information on the preferred formulary program is included in the Pharmacare Formulary Drug List. The preferred drug list pamphlet consists of two columns: the left hand column includes the “Non-Preferred Drugs” and the right hand column includes the “Preferred Formulary Alternatives.” Each “Non-Preferred” drug has at least one “Preferred” alternative available drug. Patients are encouraged to take the “Preferred Drug List” with them when they visit their doctor. You will have lower copayments when you purchase “Preferred Formulary Alternatives.”