Managing the prescription medications
     that you need to stay healthy!
You can refill or renew your prescriptions online!
At the request of SAMBA, Medco manages your prescription drug benefit under the SAMBA Health Benefit Plan (High Option and Standard Option) and the SAMBA Dependent Children Health Benefit Plan (Standard Option only). The benefit includes a list of drugs preferred by your plan. This list, sometimes called a formulary, has a wide selection of generic and brand name medications.

Bring the Preferred Prescriptions® Formulary Member Guide with you to each doctor visit to discuss whether a drug on the list is right for you. You may purchase the drugs at a retail network pharmacy or through Medco By Mail, Medco's mail-order pharmacy.

To keep your costs low, your copayment will be less when you purchase a generic or formulary brand-name drug. And, if you purchase your drugs through the Medco By Mail, mail-order pharmacy your costs are usually much lower.

Refer to your handbook for details pertaining to the plan option that you have coverage.

Your 2007 Prescription Drug Benefit Handbook (High Option)

Your 2007 Prescription Drug Benefit Handbook (Standard Option)
 

Copayments

HIGH OPTION
Prescription Drugs Plan Pays:
Preferred Provider
Plan Pays:
Non-Preferred Provider
Retail pharmacy Rx drugs and medicines – 30-day supply No deductible
100%
after copayment of:
$10 per generic
$25 per formulary name brand 
$40 per non-formulary name brand
No deductible
100%
after copayment of:
$10 per generic
$25 per formulary name brand 
$40 per non-formulary name brand, plus the difference in cost had you used participating plan network pharmacy
Mail order Rx drugs and medicines – 90-day supply No deductible
100%
after copayment of:
$10 per generic
*$5 per generic for Medicare B Primary
$45 per formulary name brand
*$20 per formulary name brand for Medicare B Primary
$60 per non-formulary name brand
*$35 per non-formulary name brand for Medicare B Primary
Not applicable

 

STANDARD OPTION
Prescription Drugs Plan Pays:
Preferred Pharmacy
Plan Pays:
Non-Preferred Pharmacy
Retail pharmacy Rx drugs and medicines – limited to initial fill, 30-day supply, and one refill No deductible
100%
after copayment of:
$10 per generic
$30 per formulary name brand 
$45 per non-formulary name brand
No deductible
Reimbursement based on SAMBA's cost of prescription at a participating retail pharmacy
Mail order Rx drugs and medicines – 90-day supply 100% after copayment of:
$20 per generic
25% of the Plan allowance
($45 minimum/$80 maximum for each) formulary name brand
25% of the Plan allowance
($60 minimum/$100 maximum for each) non-formulary name brand
Not applicable

If you have questions, you can call Medco's Member Services toll-free at (800) 283-3478, 24 hours a day, 7 days a week, except Thanksgiving and Christmas, or you can log on to Medco's website at www.medco.com. You can also contact SAMBA's Customer Service toll-free at (800) 638-6589.