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How do I fill
a prescription?
What is a
copayment? How do
I know what to pay for prescription drugs?
Why are there
different copayments for different drugs?
What happens
when my doctor prescribes a Tier Three (highest copayment amount)
drug?
What if I want the
brand name drug - not the generic?
I have always
paid the same copayment amount. The last time I filled my prescription
the copayment amount increased. Why?
Why was my
prescription not filled by my pharmacy?
What happens
if I am away from home and need prescription medication?
How do I get
my prescriptions filled by mail?
I am going
to be away for an extended period of time. What do I do about the
medications I take on a continuing basis?
How do I
receive a copy of the formulary/drug list?
Still have questions? You can email
us.
How do I fill a
prescription?
Simply take your prescription and your
ConnectiCare ID card to any participating
pharmacy. Our pharmacy network
includes the major chains as well as many local drug stores.
What is a copayment?
How do I know what to pay for prescription drugs?
A copayment is the predetermined fee you
pay for covered healthcare benefits – in this case, prescription
drugs. Your specific copayment for each tier can be found in your
Benefit Summary. Your copayment is based on the tier in which the drug
is listed.
Why are there
different copayments for different drugs?
The cost of drugs varies widely, even
among medications that treat the same condition. Generic drugs are the
least expensive and therefore have the lowest copayment. Brand name
drugs cost on average three to four times as much as generic drugs and
therefore have a higher copayment.
What happens when my
doctor prescribes a Tier Three (highest copayment amount) drug?
The prescription will be filled at a participating
pharmacy at the highest copayment amount.
Most prescription drugs that are
covered by ConnectiCare’s plan are from Tier One or Tier Two. But if
you’re using a drug from Tier Three, ask your physician if a Tier
One or Two alternative is available. Your physician will be able
discuss the available alternatives with you.
What if I want the
brand name drug - not the generic?
When generic drugs are available, your
prescription drug program covers only the cost of the generic. If you
or your physician request the brand name when a generic is available,
an additional payment is required. This additional payment represents
the cost difference between the generic and brand name.
I have always paid
the same copayment amount. The last time I filled my prescription the
copayment amount increased. Why?
There are several reasons why your
copayment could increase.
- Employers purchase health benefits
on a yearly basis. If you or your employer made changes in your
benefits, prescription copayment levels may have also changed.
- ConnectiCare reviews drugs several
times throughout the year. One of your medications may have been
moved to a new copayment tier. These changes are communicated
quarterly in our member newsletter and also in the pharmacy
portion of the Connecticare.com web site.
- Your physician may have written you
a new prescription for a different quantity. Copayments are based
on the number of month’s supply dispensed to you by the
pharmacy.
Why was my
prescription not filled by my pharmacy?
A limited number of medications
covered by ConnectiCare need prior approval from the prescribing
physician. Drugs require prior approval in these situations:
- Drug's that should be monitored to
insure appropriate use
- The medication has been prescribed
in a quantity over the set limit
Also some
drugs are not covered by ConnectiCare, including:
- Drugs used for sexual dysfunction
- Drugs used for weight loss
- Drugs used for smoking cessation
What happens if I am
away from home and need prescription medication?
Look for a participating pharmacy.
Most pharmacy chains all over the USA participate with the
ConnectiCare network.
If you use a non-participating
pharmacy, you are responsible for the full cost of the prescription at
the time of purchase. However, if there was a medical emergency and
you paid for the prescription, keep your receipt and fill out the Prescription
Drug Claim form for reimbursement.
How do I get my
prescriptions filled by mail?
Most plans offer home delivery of
prescription medications. Refer to your Benefit Summary to see if
you're covered for mail order. Our mail order service offers a
convenient way to receive up to a three-month supply of medications
that you are taking, and will be taking on an on-going basis.
- Simply have your physician write a
prescription for a three-month supply.
- Fill out the mail order form.
- Enclose the copayment and allow 14
days for your prescription to arrive.
I am going to be
away for an extended period of time. What do I do about the medications
I take on a continuing basis?
If you are away from home or plan to
be away for an extended period of time, please call Member Services at
1-800-251-7722, and we may override the day supply limit. Or if you
have a new prescription bring this to a network pharmacy anywhere in
the United States and you will only be responsible for your standard
copayment amount.
How do I receive a
copy of the Drug List?
There are three simple ways to obtain
one. You can e-mail us, call Member
Services or you can view ConnectiCare's Prescription
Drug List.* This version has a search function that will easily
allow you to find your medication.
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