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Medco
April 2004
Medco is proud
to announce that the Centers for Medicare & Medicaid Services
(CMS) selected us as one of the Medicare-approved sponsors to offer
prescription drug discount cards. Medco will offer several
Medicare-approved prescription drug discount card programs both
directly and with selected partners. Enrollment begins Monday,
May 3, 2004.
In addition to
Medco's direct-to-consumer Medicare program, we have partnered with
health plans and retail pharmacies to offer discounts on prescription
medications for Medicare-eligible customers through more than 46,000
neighborhood pharmacies nationwide.
Following is a
general description of our three program offering. More
detailed information in the form of plan sponsor announcements will
be sent to pharmacies in early May. Please note that in order
to be consistent with the intention of CMS, this information should
be used for training purposes only within the pharmacy; it should not
be shared with Medicare-eligible members directly.
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Medco
direct-to-consumer and "co-branded" discount cards:
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Are
Medicare-approved (this applies to each prescription drug discount program)
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Offer Medicare
beneficiaries discounts on their prescription drugs with savings of
up to 30% or more each time they fill a prescription
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Offer eligible
Medicare beneficiaries $600 transitional assistance credit
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Are available
nationally as a direct-to-consumer Medco branded discount card or as
a co-branded discount card
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Includes new
ID cards to be issued upon enrollment
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Are
administered under the Consumer Program Pharmacy Network, Schedule
YRX-100 agreement as amended, January 20004
Some of our
partners for co-branded cards are Bankers Fidelity Life (a subsidiary
of Atlantic American Corporation), Health Alliance Plan,
FirstCarolinaCare, Inc., Medical Mutual of Ohio, Nationwide Health
Plans, NeighborCare, Inc., Oxford Health Plans, Inc., The Health Plan
of the Upper Ohio Valley, Inc., WPS Health Insurance. By
co-branding, these partners have endorsed Medco's Medicare-approved
discount card program.
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Medicare +
Choice (M+C) health plan discount cards:
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Medco
administers several existing health plan's specific M+C pharmacy benefits.
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Current M+C
pharmacy benefits within these health plans many be enhanced with the
addition of the transitional assistance now available through the
Medicare-approved program.
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M+C members
will use ID cards as issued by the health plan.
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M+C members
will continue to use the same client-specific networks that they have
been using to obtain M+C benefits and to access the enhanced benefit.
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Health plans
receive exclusive endorsement for M+C members. These M+C can
not enroll in any other Medicare-approved discount card program.
Some of the
Medicare-approved health plan card sponsors that Medco currently
manages under the M+C pharmacy benefit are:
Highmark Blue
Cross Blue Shield (predominantly located in western Pennsylvania)
using the Highmark Premier Gold Network, Schedules B-106 revised,
B107, C-001 as amended February 2004.
UnitedHealthcare
(11 health plans) using the Medco Health Premier Retail Network,
Schedule A-900 as amended February 2004
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Client-branded
discount card:
This program
is administered under the Consumer Program Pharmacy Network, Schedule
YRX-100 agreement as amended in January 2004. UnitedHealthcare
will market the program nationally under the name of U Share
Prescription Drug Discount Card, and new ID cards will be issued.
Electronic
claims submitted by pharmacies for the Medicare-approved programs
administered by Medco must be submitted to RxBIN 610014 in the
current NCPDP v5.1 claim standard. Additional details including
sample ID cards. RxGroup numbers, and program specifics will
follow. And note that Frequently Asked Questions will be posted
on the Pharmacist Resource Center website at www.medco.com/rph
by early May.
Sincerely,
Medco |
