Chair Talk

April 2017

The majority of calls and e-mails I have received over the past 3 months since our Prescription Drug Provider has changed from MedImpact to OptumRx have been about the formulary changes. Most Rx providers do not have the same formularies therefore when there is a provider change there may be a formulary change as well. Most of the drug changes have involved the drug going from a Tier 2 ($60) under the MedImpact formulary to a tier 3 ($120) under the OptumRx formulary. A formulary change is not a change in benefits!

The Prescription Drug Plan itself has not changed. The co-pays remain the same:

Co-pays30 –Day Supply90-Day Supply
Tier 1: Generic$10$20
Tier 2: Preferred Brand$30$60
Tier 3: Non-Preferred Brand $60$120

I have learned over the years that many retirees (and active employees as well) do not read the benefit information that is mailed to all of us. It’s important that you read and understand what you receive about your benefits. In the information we received from OptumRx is the 2017 Abridged Formulary. This document gives us information as to what a formulary is, how to use the formulary, restrictions on coverage, how to request exceptions etc. The document also lists drug names, tiers and requirements/limits. This document is not a complete list—a complete list is on the OptumRx or Employee Benefits website. If you have a question about your drug you can call OptumRx Member Services at 1-866-635-5941 (24 hours a day, seven days a week).

Editor’s note: Bob Kopasz is Chair of the Michigan SERA Council. He may be reached at P.O. Box 692, Mt. Morris, MI 48458; phone 810/240-8380.