Frequently Asked Prescription Questions

Frequently Asked Prescription Questions

1. Q. What is my annual prescription drug benefit?

A. For specific details see your Group Reimbursement Welfare Plan booklet. The dollar limit indicated refers to the total cost of the drugs billed, not to a tally of your co-payments.

2. Q. How do I obtain my Group Reimbursement Welfare Plan booklet?

A. See your Shop Steward and ask him/her to obtain a copy for you from your Local 464A Union Agent or Service Representative.

3. Q. Can I use the UFCW Local 464A Prescription Drug (Express Scripts) card if I have prescription drug coverage under another plan?

A. The UFCW Local 464A prescription program is a secondary plan. This means that if you are covered under any other insurance plan, you must first use the prescription drug benefit from that other plan

4. Q. What if the other prescription plan doesn’t cover the full cost of the prescription, how do I apply for reimbursement of my prescription bills?

A. Prepare a UFCW Local 464A Welfare Fund Prescription Claim Form, attach a copy of your prescription receipt(s) and the Explanation of Benefit (EOB) from your other prescription plan and send all to the Prescription Department at the Local 464A Little Falls, NJ headquarters. Your claim will be reviewed and processed by Express Scripts.

5. Q. Where can I obtain this form?

A. Click on Forms on this site or call the Local 464A Prescription Department in Little Falls, NJ at 973.256.5803.

6. I am a part-time employee; can I add my dependents to my medical coverage?

A. You must contact the Benefits Department for specific Plan guidelines for enrolling your eligible dependents under the Plan.

7. Q. How much do I have to pay for prescriptions when I use my Local 464A Express Scripts Prescription Card at my pharmacy?

A. Your co-payment is $2.00 for a generic and $5.00 for a brand-name drug.

8. Q. I just noticed that I am paying more for my prescriptions, why?

A. This may be because you have reached your monthly prescription allowance. See your Group Reimbursement Welfare Plan booklet for prescription coverage.

9. Q. How can I find out if I have reached or exceeded my annual prescription allowance maximum?

A. Call 1.800.451.6245. This is the Customer Service number on the back of your Express Scripts prescription card. NOTE – When asked for an address and telephone number give the UFCW Local 464A address: 245 Paterson Ave. Little Falls, NJ 07424 and tel. no. 973.256.6790

10. Q. But I must have my prescriptions even if I have exceeded my monthly allowance, is there anything I can do?

A. In certain instances if the condition being treated with the prescription is life-threatening, an extension may be provided. This applies only to most eligible full-time employees and requires a letter from the treating physician clearly stating that the condition if left untreated, may be life-threatening. This letter must be prepared by the treating physician on his/her official stationery (letterhead), state the diagnosis, and be addressed to the Prescription Department C/O the Little Falls, NJ office.

11. Q. Do extensions of prescription drug coverage because of a life-threatening illness apply to my whole family?

A. No, as reported in the September 2007 issue of the Sentinel, the extension of prescription drug coverage because of a life-threatening illness only applies to the member or dependent diagnosed with a life-threatening illness, and not the entire family. In effect, this means that members or dependents who have not been so diagnosed, will not be provided extended prescription drug coverage.

12. Q. Are there limits on the supply I can obtain with each prescription?

A. Yes. Covered prescriptions are limited to a maximum 34-day supply

13. Q. Where can I get my prescriptions filled?

A. Following is a shortlist of participating pharmacies:

 ACME                Rite-Aid

 CVS                    Shop Rite

 Duane Reade   Stop & Shop

 Eckerd              Waldbaums

 Genovese   

 

14. Q. What if I need an emergency prescription when I am out of town?

A. You may use your UFCW Local 464A Express Scripts Card at pharmacies nationwide

15. Q. Are there medications that are not covered under the Prescription Plan?

A. Yes. Over-the-counter items are not covered. Other items specifically excluded are oral contraceptives, fertility medications, allergy serums, vaccinations, injectable medications, and therapeutic devices

16.Q. Does the Prescription Plan cover smoking cessation products?

A. Only prescription smoking cessation products are covered

17.Q. What should I do if my pharmacist tells me he/she is having trouble processing my prescription with my Express Scripts card?

A. This happens occasionally. Ask the pharmacist to call 1.800.235.4357. This is the Express Scripts pharmacy assistance number on the back of your Express Scripts prescription card.

18.Q. What should I do if I lose or damage my Local 464A Express Scripts Prescription card?

A. Contact the Prescription Department at 973.256.5803 for a replacement card.