Download Windstream Prescription Drug Plan

2013 Windstream Retiree Prescription Drug Plan
Administered by Express Scripts
For All Windstream Retirees
The Windstream Prescription Drug Plan provides coverage for retirees enrolled in
Windstream medical plans. Windstream offers prescription coverage through Express
Scripts. Co-payments are required, and an economical Home Delivery service must be
used for maintenance medications.
If you have any questions regarding coverage for a particular medication or device, when
a brand name penalty will be applied, plan exclusions, prior authorizations, Step
Therapy, or in understanding a provision of the Windstream Prescription Drug Plan,
please contact Express Scripts directly.
Express Scripts Contact Information
Phone:
1-866-804-7613
Web site:
www.express-scripts.com
Express Scripts Participating Pharmacies
The Express Scripts network includes over 50,000 pharmacies nationwide. Confirmation
of Participating Pharmacies may be obtained by calling Express Scripts at 1-866-8047613 or by accessing their Web site at www.express-scripts.com.
Express Scripts Formulary Drug List
You may obtain a Formulary Drug List at any time by calling the Windstream Benefits
Center at 1-888-392-7597, or by contacting Express Scripts directly, or logging onto
Express Scripts to check the status of your drug. The formulary list is provided to assist
retirees in lowering out-of-pocket expenses; non-formulary drugs usually require a
higher co-payment, so lower-cost alternatives are listed in the formulary chart. The
formulary list is not a complete list of all drugs covered under the Prescription Drug Plan.
For additional information, please contact Express Scripts and/or your pharmacist. The
formulary list does change periodically. For the most up-to-date list, contact Express
Scripts.
Retail and Mail Order Benefits
You may purchase up to a 30-day supply from retail pharmacies (using your Express
Scripts ID card at participating network pharmacies). In addition, your benefit plan
has a Mandatory Mail Order Program for maintenance medications (up to a 90day supply). An Express Scripts Maintenance Medication list indicating the medications
that must be obtained through mail order is available upon request. You will be able to
obtain your original prescription for a maintenance medication plus one refill at a local
retail pharmacy. Thereafter, you must obtain your maintenance medication prescription
refills using the Express Scripts home delivery pharmacy. You can get started with Home
Delivery via the web or by phone. Your prescriptions can be mailed to: Express Scripts,
P.O. Box 66566, St. Louis, MO 63166-6566.
Please use an Express Scripts mail order form (can be obtained online or by calling
Express Scripts). The mail order form confirms your Member ID, method of payment,
Effective Jan. 1, 2013
etc. Your Physician can also fax your prescription to Express Scripts. Only Physician
offices are allowed to use this fax number. Fax: 1-866-662-5267
Step Therapy
Step Therapy encourages the use of generic drugs since generics help you and
Windstream get your medicine at the lowest possible cost.
How Does Step Therapy Work?
• Front-Line Medications: These are the drugs recommended for you to take first —
usually generic medications, which have been proven safe and effective.
• Back-Up Medications: These are brand-name medications. They’re recommended
for you to take if a front-line medication doesn’t work for you.
If you’ve already tried a front-line drug, or your doctor decides one of these drugs isn’t
appropriate for you, then your doctor can prescribe a back-up drug, but at a higher cost.
For more information on how the program works and how it benefits you, contact
Express Scripts at 1-866-804-7613.
Co-Payment Schedule
Using generics helps you get your medicine at the lowest possible cost.
Retail pharmacy co-payments per script
Generic (30-day supply)
Formulary Brand-Name (30-day supply)
Nonformulary (Non-preferred) Brand Name (30day supply)
2013
$10.00
$40.00
50% of the cost
$40.00 minimum
Home Delivery (Mail order)
co-payments
Generic (90-day supply)
Formulary Brand-Name (90-day supply)
Nonformulary (Nonpreferred) Brand Name (90day supply)
Specialty Medications (Mailed from Express
Scripts’ specialty pharmacy: CuraScript)
Drugs requiring CuraScript delivery via mail
order (maximum 30-day supply) after one retail
fill
2013
$20.00
$80.00
50% of the cost
$80.00 minimum
50% of the cost
$100.00 maximum
per script
Specialty medications (requiring CuraScript delivery) are those used for chronic disease
states such as (but not limited to): Hepatitis, Multiple Sclerosis, Growth Hormone
Deficiency, Rheumatoid Arthritis, Infertility, Hemophilia, and Oncology.
This document is intended as an overview of the Windstream Prescription Drug Plan. In the event of a
discrepancy between this summary and the official Plan Document, the Plan Document will control. In the
event of any misstatement of any fact(s) affecting coverage under the Plan, the Plan shall be used to
determine the proper coverage. Coverage means eligibility as well as the amount of any Benefit thereunder.
Windstream reserves the right, in its sole discretion, to modify, change, revise, amend, or terminate any plan
at any time, for any reason, and without prior notice, including subsidy levels.
Effective Jan. 1, 2013