C and O Employees' Hospital Association
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C and O Employees' Hospital Association
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2010 NOTICE OF CHANGE IN MEDICAL BENEFITS ACTIVE AND RETIRED, NON -MEDICARE MEMBERSDue to the continuing increase in health care and pharmacy costs, the C and O Employees’ Hospital Association Board of Directors found it necessary to increase the office visit, office consultation and emergency room copayments. Effective January 1, 2010, the new medical copayments will be as follows:
Also, effective January 1, 2010, Plan Two (80% Coverage, Waiver of Premium) changes as follows . For more information on Plan Two, please refer to pages 20, 21, 22, 28 and 29 of the enclosed Rules and Regulations.
Please find enclosed your 2010 C and O Employees’ Hospital Association Active/Retired Non-Medicare Rules and Regulations . This is your Evidence of Coverage. It explains your rights, benefits and responsibilities as a member of the C and O Employees’ Hospital Association ("COEHA"). We are listing below the changes and page numbers where they can be found. Some of the changes may include additional benefits, actual changes to an already existing benefit, or changes in the description only of the service. We did not list the instances where we updated the copayment amounts or changed Plan Two to 80% coverage.Page 8, Plan Eligibility Page 42-43 Gastric Bypass Surgery/Lap BeltPages 9-10, COEHA Board of Directors Page 43, Removal of Excess Skin Pages 20-21, Disabled Members Page 45, Mental Health Page 28, Plan Two Pages 45-46, Substance Abuse Page 36, Foot Orthotics Pages 46-49, Prescription Drugs Page 36, Description of Prosthetic Devices Pages 51-52, Exclusions Page 38, Emergency Room Benefits Pages 53-60, Subrogation and Reimbursement Page 39, Skilled Nursing Facility Care If you have any questions, please do not hesitate to call us toll free at 1-800-679-9135 or local residents in the Clifton Forge area at 862-5728. Sincerely, Jack N. Pate Enclosure
2010 NOTICE OF CHANGE IN PRESCRIPTION DRUG BENEFITS ACTIVE AND RETIRED, NON MEDICARE MEMBERS
Due to the continuing increase in health care and pharmacy costs, the C and O Employees’ Hospital Association Board of Directors found it necessary to increase the prescription drug copayments. Effective January 1, 2010, the new copayments will be as follows:
Our prescription drug plan is administered by informedRx. You can reach informedRx at 1-800-777-0074 or visit them at www.myinformedrx.com.We have developed the following list of our most frequently asked questions and our responses for your easy reference: How will I know which local pharmacies are in the informedRx network? Most of the major pharmacies as well as a number of independent pharmacies are contracted with informedRx. You can check with your pharmacy or call informedRx at 1-800-777-0074. You can also check the informedRx web site. If your local pharmacy is not in the network, please let us know and we will have informedRx contact your pharmacy to see if they are interested in becoming a part of their network.Are there any local pharmacies through which I can get a 90-day supply without having to use mail order? Yes, all Walmart and Kroger Pharmacies will handle 90-day prescriptions. These pharmacies have agreed to accept the mail order copay for a 90-day fill. There are a few independent pharmacies that have also agreed to do this. You may call COEHA for information on the independent pharmacies.How do I utilize the mail order services? If you are ordering by mail for the first time, you will need to complete and return to informedMail (the mail order pharmacy) a patient profile form listing any drug allergies, etc., to submit prior to or with your first mail order and you will need a credit or debit card. If you do not have the necessary mail order paperwork, you can call us or informedRx. You can also download these forms from the informedRx web site.Where is the mail order pharmacy for informedRx located? Their mail order pharmacy is located at 9994 Premier Parkway, Miramar, Florida 33025.How many days in advance should I order my prescriptions? informedMail fills 95% of their mail order prescriptions within 48 hours. However, you should order all initial prescriptions 30 days in advance. Refills should be ordered 14 days in advance.Can I call for a refill of a mail order prescription drug rather than reorder by mail? Yes, call informedMail at 1-800-881-1966. What if I want a brand name drug when a generic is available? You will be charged a brand name copayment and the difference between the cost of the brand name drug and the generic drug. How will I purchase my diabetic testing supplies? You will be able to purchase a 30-day supply through the local network pharmacies and a 90-day supply through the mail order program. Also, you can purchase a 90-day supply through your local Walmart or Kroger at the same price as the mail order copay.If you have any additional questions or if we can assist you in any way, please do not hesitate to call us toll free at 1-800-679-9135 or local residents in the Clifton Forge area at 1-540-862-5728. Our hours of operation are Monday through Friday, 8:30 to 5:00 pm (EST). Sincerely, Jack N. Pate |
