State Teachers Retirement Board Changes Drug Plan to Mail Order

The following changes to the STRS Ohio Prescription Drug Program will affect enrollees in the Aetna U.S. Healthcare and Medical Mutual
of Ohio PPO and indemnity plans, Paramount Health Care HMOs, and The Health Plan of Upper Ohio Valley HMOs beginning January 1, 2001.

• Deductible. STRS Ohio is implementing a $50 annual deductible for each participant in the prescription drug program. .

 

• Co-payments. Co-payments will increase for prescription drugs purchased through both Merck-Medco's PAID Prescriptions Retail Pharmacy Program and Merck-Medco's Rx Services Mail-Service Program.

 

• New formulary. Beginning January 1, 2001, a new drug formulary will be used. About 100 of the 900 medications on the current plan formulary will be considered non-formulary and subject to a higher co-payment.

 

• Retail pharmacy fill limits. Beginning January 1, 2001, plan participants will be able to obtain only three "fills" of the same maintenance medication at the same dosage level when using a participating retail pharmacy. Each fill can be for up to a 34-day supply. Retail plan benefits then stop for that medication. After three fills, the plan participant must obtain a new prescription for a 90-day supply from his doctor and have it filled using Merck-Medco's Mail-Service Program. The three fills can include the original fill of a prescription and two refills of the same medication, or three refills of the same medication. Individuals currently taking maintenance medications will receive a letter in December explaining how to use the Mail-Service Program.

 

• Mail-service supply change. For prescriptions received through the Mail-Service Program, the days supply will change from 120 days to 90 days.
  
  
  OPA encourages its members to contact their State Senators and Representatives immediately to express your concerns over these changes. Also, be sure to tell retired teacher patients to contact their legislators and the State Teachers Retirement System with their concerns. If they are unsure of who their legislators are, have them call the county Board of Elections. For information on how to contact your legislators, please visit the government affairs section
  of our website at
  www.ohiopharmacists.org/government.html or contact Alon Apel or Ernie BBoyd at 614.798.0037.