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Understanding Prescription Benefits

Understanding Prescription Benefits. Did you know… Most pharmacies will charge you the co-pay amount for a generic drug even if it is offered on their discount plan for less. The following are a few pharmacies that offer discount generic drug plans: CVS Walgreens Wal-Mart/Sam’s

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Understanding Prescription Benefits

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  1. Understanding Prescription Benefits • Did you know… • Most pharmacies will charge you the co-pay amount for a generic drug even if it is offered on their discount plan for less. • The following are a few pharmacies that offer discount generic drug plans: • CVS • Walgreens • Wal-Mart/Sam’s • Kroger • You could save approximately $120.00 per year on just 1 generic maintenance medication by using the pharmacy discount plans instead of your insurance co-pay!

  2. Tips for Choosing a Medical Plan • Estimate the number of sick visits you and your dependents • use in a typical year. • Tip: Use the same number of visits that you had the previous year. Information can be found on the Blue Access website. • Find out the actual cost (not the co-pay cost) of any maintenance medication that you currently take. • Tip: You can print off a list of all prescriptions filled and their actual cost for the last 18 months on the Medco website. • Find out the actual cost of any prescriptions utilized for sickness in the past year. • Tip: If you do not have access to the Medco website, you can contact your pharmacy for a list of prescriptions filled and their actual costs. • Calculate the annual premium cost for each plan offered. Then add the above totals to that premium to find out the average annual cost for you and your family on each plan.

  3. Plan Comparison – EO coverage

  4. Plan Comparison – E+C coverage

  5. TRS-ActiveCare Medical Premiums

  6. American Public Life MEDlink® Plan • *MEDlink is designed to supplement your employer’s medical plan. This plan • provides supplemental coverage to help offset out-of-pocket costs that you may experience due to deductibles and coinsurance of your employer’s medical plan. • In-Hospital Benefit • Pays expenses you incur as an Inpatient (at least 18 continuous hours) up to $2,500 or $1,500 per confinement (based on plan you select). • Out-patient Benefit • Pays up to $200.00 per treatment in: • Hospital Emergency Room • Outpatient surgery in a Hospital Outpatient Facility • Outpatient surgery in a free-standing Outpatient Surgical Center • Diagnostic testing in a Hospital Outpatient Facility • Diagnostic testing in a MRI Facility • All benefits for the same or related conditions will be subject to the maximum benefit, unless such conditions are separated by 90 consecutive days, then a new maximum out-patient benefit will apply. • Physician Benefit: • Physician visits for sickness or injury due to an accident: $25.00 per visit, maximum five visits per family per calendar year, for treatment received in a: • Physician’s office • Hospital Outpatient Clinic • Free-standing Emergency Care Clinic • *This policy has limitations and exclusions. Please refer to the policy and brochure for benefits and provisions.

  7. MEDlink® – Example of Savings INPATIENT HOSPITAL EXAMPLE: Illness: Pneumonia (@ hospital in Plano, TX) Estimated cost after insurance adjustments = $8,258

  8. American Public Life – MEDlink® Monthly Premium Comparison: Assumes Employee age 45 with $225 employer/State contribution to medical plan.

  9. MEDlink®Eligibility • *You are not eligible for the MEDlink plan if any • of the following apply to you: • Covered by TRS-Care, Medicare, Medicaid or Medical Savings Accounts. • Employees who have an HSA that is being actively funded. • Employees (or their dependents) who are not covered under the school’s major medical plan. • Non-residents of the United States. • Employees not actively at work on the plan effective date. • *This policy has limitations and exclusions. Please refer to the policy and brochure for benefits and provisions.

  10. MEDlink®Monthly Premiums $1500 Benefit MONTHLY RATES In-Hospital Benefit $1,500 Ages 18-54 Employee Only 21.50 Employee & Spouse 39.50 Employee & Children 36.50 Employee & Family 54.50 Ages 55-59 Employee Only 32.00 Employee & Spouse 59.00 Employee & Children 47.00 Employee & Family 74.00 Ages 60 & Over Employee Only 49.00 Employee & Spouse 88.00 Employee & Children 64.00 Employee & Family 103.00 $2500 Benefit MONTHLY RATES In-Hospital Benefit $2,500 Ages 18-54 Employee Only 28.00 Employee & Spouse 51.50 Employee & Children 45.50 Employee & Family 69.00 Ages 55-59 Employee Only 44.50 Employee & Spouse 81.50 Employee & Children 62.00 Employee & Family 99.00 Ages 60 & Over Employee Only 68.50 Employee & Spouse 122.50 Employee & Children 86.00 Employee & Family 140.00

  11. Contact Financial Benefit Services at 800.583.6908 if you have questions or need enrollment assistance. any questions.

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