CITY TO STAY WITH MEDCO FOR 2012
The City of Mesa has decided to stay with our current
Pharmacy Benefits Manager (PBM), Medco, for 2012.
This decision has been made after complicated and
time-consuming contract negotiations with the proposed vendor, InformedRx. We
were unable to reach a contract agreement during the final negotiation stage.
One important reason that we could not reach agreement is because InformedRx
would not honor the commitment they made during the proposal process to provide
5 to 7 day delivery of medications in writing. The best they would guarantee was
14 days.
We have reached an agreement with our current provider,
Medco, to continue with their services for 2012. While I understand that this
will disappoint some members, it was the least disruptive option available to us
for January 1. Since Medco is our current provider there should be little to no
impact on current or future services. Also, Medco has agreed to honor the
proposal they submitted during the RFP process, which means the cost savings we
had anticipated for the new plan year will remain intact.
You may receive ID cards or other information from Informed
Rx. If you do, please disregard and dispose of it. You should use your current
ID card as indicated in the FAQs below until you receive a new Medco ID card.
We apologize for any inconvenience this may have caused
members and we will strive to make this process as seamless as possible. Please
read these FAQs for more information regarding this important change.
FAQs FOR THE 2012 PRESCRIPTION DRUG PROGRAM
Who will my Prescription provider be in January?
Medco Health will continue as our Pharmacy Benefits Manager
going into the 2012 plan year.
Why did the City of Mesa decide to stay with Medco?
The City of Mesa strives to provide its participants with a
quality and cost effective prescription program that provides value to everyone
involved. The decision to stay with our current Pharmacy Benefits Manager (PBM),
Medco, was made because the provider we originally selected, Informed Rx, would
not commit to several conditions in their contract that we believed were in the
best interest of our members. One major area of concern was their refusal to
commit to a delivery time for prescriptions of less than fourteen days from the
date the prescription was received, although the City was promised a 5 to 7 day
delivery time during the proposal evaluation process.
During the final negotiation stage, we decided that remaining with Medco
would provide the least disruption for our members.
Does this change also apply to those who have selected the Out-of-State
plan (retirees or dependents who live outside of Arizona)?
Yes, Medco will be the pharmacy benefit manager for the
City of Mesa for both in-state and out-of-state members. Out-of-state members
will receive a medical/prescription card that will come from Blue Cross Blue
Shield. Every effort will be made to get ID cards to the out-of-state members by
January 1, but if they are not received by that date, you should:
1.
Use your current card
for the pharmacy only.
2.
Request medical providers to call BCBS at
866-288-5788 to verify out-of-state coverage and for instructions on submitting
claims.
Will I still get a new member ID card in 2012? If so, when?
You may continue to use your current medical/prescription
card until you receive your new medical/prescription card from Medco in the
mail. You will receive your new card by January 16. If you need a replacement card in the
meantime, you can print a temporary prescription card at medco.com or call
Medco. Temporary replacement medical cards will be available from Benefits
beginning December 28. Note for
out-of-state members: you will receive a medical/prescription card that will
come from Blue Cross Blue Shield.
Every effort will be made to get ID cards to the out-of-state members by January
1, but if they are not received by that date, you should:
1. Use your current card for the pharmacy only.
2.
Request medical providers to call BCBS at 866-288-5788 to verify out-of-state
coverage and for instructions on submitting claims.
What will happen to my current prescriptions and mail order?
Will my prescriptions automatically
refill after January 1 now that the City is staying with Medco?
You will be able to continue using your Medco plan without
interruption. You will be able to refill your mail order prescriptions or fill
prescriptions at any Medco participating retail pharmacy (subject to the retail
penalty after 3 fills) just as you always have. If you are enrolled in the
automatic refill program, your refills will continue to be sent to you. You will
need to contact your physicians office for a new prescription if you have no
remaining refills or your prescription has expired.
Since the City is moving back to Medco, will the changes to the
deductible, coinsurance
and copays
outlined in the work book in What's New for 2012 still apply?
Medco has agreed to honor its proposal for 2012, including
the cost savings, which are about the same as those offered by Informed Rx. This
means that the changes to the members cost outlined in the 2012 workbook will
still apply; however, they will not be effective until January 16, 2012.
Will Medco let you get three months of generic prescriptions at a retail
pharmacy and only pay for 2 months copay/coinsurance? If so, when will it start?
You will be able to get three months of generic
prescriptions at the retail pharmacy for two months copay from Medco effective
February 1, 2012.
Are there any changes to Medco’s pharmacy network or formulary effective
January 2012?
There are no significant changes to either the Medco
network or the formulary for 2012 at this point. However, formulary changes do
occur throughout the year, and we expect there will be some in 2012 as a result
of several brand names going generic throughout the year.
You can visit the Medco website,
www.medco.com, for the most current formulary listing.
I have heard that Express Scripts and Medco are two of the country's
largest pharmacy benefit managers and that they will be merging. Is this going
to happen soon?
During our evaluation process, Medco and Express Scripts
were two of our top three choices when Express Scripts announced that they were
purchasing Medco. The merger is to be finalized in 2012. We will be following
these developments closely to determine the effect that they will have on our
members; however, all indications are that this merger will result in
improvements in services for us.
Who do I contact if I have questions about my pharmacy benefit?
Please contact Medco Customer Care toll-free at the number
listed on your medical/prescription benefit member ID card for questions
pertaining to your pharmacy benefit:
Special toll-free line for City of
Mesa members
1-877-476-9270
Medco Member Services
Medco website
1-800-711-0917
www.medco.com
For Benefit Design and eligibility
questions contact the Employee Benefits Office:
Phone: 480-644-2299 Option 2
Email: Benefit.Info@mesaaz.gov
***************************************************************
Effective January 1, 2012, the EAP Vendor
will be changing to ComPsych. Please do not attempt to contact them prior
to 1/1/12 as they will not be able to assist our subscribers at this time.
You can view their website and their
flyer here.
FAQs
FAQs FOR THE 2012 PRESCRIPTION DRUG PROGRAM
Who will my Prescription provider be in January?
Medco Health will continue as our Pharmacy Benefits
Manager going into the 2012 plan year.
Why did the City of Mesa decide to stay with Medco?
The City of Mesa strives to provide its participants
with a quality and cost effective prescription program that provides value
to everyone involved. The decision to stay with our current Pharmacy
Benefits Manager (PBM), Medco, was made because the provider we originally
selected, Informed Rx, would not commit to several conditions in their
contract that we believed were in the best interest of our members. One
major area of concern was their refusal to commit to a delivery time for
prescriptions of less than fourteen days from the date the prescription was
received, although the City was promised a 5 to 7 day delivery time during
the proposal evaluation process.
During the final negotiation stage, we decided that remaining with Medco
would provide the least disruption for our members.
Does this change also apply to those who have selected the Out-of-State
plan (retirees or dependents who live outside of Arizona)?
Yes,
Medco will be the pharmacy benefit manager for the City of Mesa for both
in-state and out-of-state members. Out-of-state members will receive a
medical/prescription card that will come from Blue Cross Blue Shield. Every
effort will be made to get ID cards to the out-of-state members by January
1, but if they are not received by that date, you should:
1. Use your current card
for the pharmacy only.
2.
Request medical providers to call BCBS at
866-288-5788 to verify out-of-state coverage and for instructions on
submitting claims.
Will I still get a new member ID card in 2012? If so, when?
You may continue to use your current
medical/prescription card until you receive your new medical/prescription
card from Medco in the mail. You will receive your new card by January 16. If you need a replacement card in the
meantime, you can print a temporary prescription card at medco.com or call
Medco. Temporary replacement medical cards will be available from Benefits
beginning December 28. Note for
out-of-state members: you will receive a medical/prescription card that
will come from Blue Cross Blue Shield.
Every effort will be made to get ID cards to the out-of-state members
by January 1, but if they are not received by that date, you should:
1. Use your current card for the pharmacy only.
2.
Request medical providers to call BCBS at 866-288-5788 to verify
out-of-state coverage and for instructions on submitting claims.
What will happen to my current prescriptions and mail order?
Will my prescriptions automatically
refill after January 1 now that the City is staying with Medco?
You will be able to continue using your Medco plan
without interruption. You will be able to refill your mail order
prescriptions or fill prescriptions at any Medco participating retail
pharmacy (subject to the retail penalty after 3 fills) just as you always
have. If you are enrolled in the automatic refill program, your refills will
continue to be sent to you. You will need to contact your physicians office
for a new prescription if you have no remaining refills or your prescription
has expired.
Since the City is moving back to Medco, will the changes to the
deductible, coinsurance
and
copays outlined in the work book in What’s New for 2012 still apply?
Medco has agreed to honor its proposal for 2012,
including the cost savings, which are about the same as those offered by
Informed Rx. This means that the changes to the members cost outlined in
the 2012 workbook will still apply; however, they will not be effective
until January 16, 2012.
Will Medco let you get three months of generic prescriptions at a retail
pharmacy and only pay for 2 months copay/coinsurance? If so, when will it
start?
You will be able to get three months of generic
prescriptions at the retail pharmacy for two months copay from Medco
effective February 1, 2012.
Are there any changes to Medco’s pharmacy network or formulary effective
January 2012?
There are no significant changes to either the Medco
network or the formulary for 2012 at this point. However, formulary changes
do occur throughout the year, and we expect there will be some in 2012 as a
result of several brand names going generic throughout the year.
You can visit the Medco website,
www.medco.com, for the most current formulary listing.
I’ve heard that Express Scripts and Medco are two of the country’s
largest pharmacy benefit managers and that they will be merging. Is this
going to happen soon?
During our evaluation process, Medco and Express
Scripts were two of our top three choices when Express Scripts announced
that they were purchasing Medco. The merger is to be finalized in 2012. We
will be following these developments closely to determine the effect that
they will have on our members; however, all indications are that this merger
will result in improvements in services for us.
Who do I contact if I have questions about my pharmacy benefit?
Please contact Medco Customer Care toll-free at the
number listed on your medical/prescription benefit member ID card for
questions pertaining to your pharmacy benefit:
Special toll-free line for
City of Mesa members
1-877-476-9270
Medco Member Services
Medco website
1-800-711-0917
www.medco.com
For Benefit Design and eligibility
questions contact the Employee Benefits Office:
Phone: 480-644-2299 Option 2
Email: Benefit.Info@mesaaz.gov
*************************************************
Who is our vision provider?
Our vision
provider is currently Vision Service Plan (VSP). You can located a
provider by visiting their website at
www.vsp.com or by contacting their customer service at 1-800-877-7195.
I'm a retiree
and would like to keep abreast of retiree issues, what resources are
available?
Of course, this Benefits site contains
a lot of information that pertains
to retirees, but also consider membership in RECOM (Retired Employees City
of Mesa) a group of close to 700 retirees, spouses/partners. To become a
member or learn more go to www.recomaz.org.
Is Open Enrollment the only time I can make changes to my
healthcare benefits?
No. You can make changes to your benefits when you experience a
qualifying change in family status, called a "qualifying event." Situations
considered to be qualifying are marriage, divorce, birth of or adoption of
child, or involuntary loss of healthcare coverage. Members have 31 days from the event date to enroll
dependent(s) to the insurance plans.
What happens if I fail to add my dependent to my insurance
within the 31-day timeframe?
If a dependent is not added within the 31-day timeframe, the member must wait until the following open enrollment period
enroll the dependent, and no
exceptions are made.
Need more information about your Benefits ID card?
Click here.