Rx: Prescription Drug Benefits

GIC Medicare and Non-Medicare prescription drug information

Non-Medicare

CVS Caremark is the GIC’s prescription drug benefit administrator for non-Medicare health insurance plans. Use your CVS Caremark ID card when filling prescriptions.

You have access to a broad network of retail pharmacies to fill a 30-day supply. You can fill a 90-day supply through mail order or at a CVS retail pharmacy. The specialty prescription drug pharmacy is changing from Accredo to CVS Specialty*.

*Specific medications may be covered through Accredo under your CVS pharmacy benefit.

Medicare

CVS Silverscript is the GIC’s prescription drug benefit administrator for Medicare health insurance plans. Your prescription drug benefit is called an Employer Group Waiver Plan. It combines a standard Medicare Part D drug plan with additional coverage provided by the GIC.

Prescription Drug Copayments

Both non-Medicare and Medicare GIC health insurance plans feature a three-tier copay structure.

• Tier 1: You pay the lowest copayment. Most generic drugs fall into this tier.
• Tier 2: You pay the mid-level copayment. Many brand-name drugs fall into this tier.
• Tier 3: You pay the highest copayment. This tier includes brand-name and generic drugs that don’t fall into Tiers 1 or 2.

Covered drugs may change when your Prescription Benefit Manager updates its drug formulary. Please check in with your Prescription Benefit Manager for the latest information on covered prescription drugs.

Prescription Drug Deductible

GIC non-Medicare health insurance plans have a fiscal year Rx deductible of $100 individual/$200 family. The prescription drug deductible is separate from your health insurance deductible. Once you’ve paid your prescription deductible, your covered prescription drugs will be subject to a copayment.

GIC Medicare health insurance plans do not have a fiscal year Rx deductible.

Medicare Part D Prescription Drug Coverage

IMPORTANT

• All GIC Medicare insurance health plans include Medicare Part D coverage. Do not enroll in a non-GIC Medicare Part D product. If you enroll in another Part D product, the Centers for Medicare and Medicaid Services will disenroll you from your GIC coverage. This means that you will lose your GIC health, behavioral health, and prescription drug benefits.
• A “Notice of Creditable Coverage” is located in your plan handbook. It provides proof that you have comparable or better coverage than Medicare Part D. If you should later enroll in an individual Medicare drug plan because of changed circumstances, you must show the Notice of Creditable Coverage to the Social Security Administration to avoid paying a penalty.
• If you have extremely limited income and assets, contact the Social Security Administration to find out about subsidized Part D coverage.
• If your adjusted gross income, as reported on your federal tax return, exceeds a certain amount, Social Security will impose a monthly additional fee called IRMAA (Income-Related Monthly Adjustment Amount). Visit medicare.gov for more information. Social Security will notify you if this applies to you.