For many years, the Metro-ILA Pharmacy Plan allows “maintenance” medications to be filled at a retail, over-the-counter pharmacy, for a total of three (3) times (original prescription plus two (2) refills)*. (Examples of “Maintenance Medications” are drugs needed for the ongoing treatment of acid reflux, cholesterol, allergies, anxiety, arthritis, asthma, diabetes, high blood pressure, etc.)
Beginning with the fourth (4th) refill and thereafter, the Plan requires participants to use Cigna’s “Tel-Drug” Mail Order service in order for maintenance medications to continue to be covered under the Plan.
Over six months ago, we learned that Cigna had not been administering this feature of the Pharmacy Plan for some time. The Fund Office instructed Cigna to resume the mail-order provision in order to comply with the long-established Plan design.
Cigna resumed this feature on July 1, 2010, but the Fund Office was not notified of this date in advance. Consequently, we were unable to inform you in time for you to make necessary arrangements to begin receiving your maintenance medications through “Tel-Drug”.
For this reason, we apologize for any inconvenience and misunderstanding this may have caused you or any of your family members.
On the positive side, however, making the transition to Tel-Drug is very simple. Cigna’s “QuickSwitch” service allows you to call a toll free number and set up mail order delivery by phone. Call 1.800.285.4812 to get started. You will need the following information when you call:
- Your Name and Cigna ID number
- Prescription medication names (for you or a covered family member)
- Doctor information (name and phone number)
- Payment information (American Express, Discover, MasterCard or VISA). This is needed for your co-pays. Remember, there is no co-pay for generic medications.
Cigna will the call your doctor’s office to request a prescription. Once they receive it, Cigna will fill the prescription and mail it to your home or other location of your choice.
Additionally, Cigna Tel-Drug will mail you a 60-day supply of each maintenance medication, instead of a 30-day in a retail pharmacy. (Co-pays, when applicable, are charged to each 30-day supply of your maintenance medications.)
Please call the Fund Office with any questions about the mail order feature of the Plan and the Cigna Tel-Drug program. Due to the circumstances under which this program was re-started, we can assist you with a one-time override at your local pharmacy in order to ensure that there is no interruption in getting the medications you need.
To request a one-time override, please contact Marisol DeJesus at 201-842-0202, ext 120. She can also assist you with any additional questions.
*Where to find the mail order provision of the Pharmacy Plan for maintenance drugs: This plan provision is found in on pages 52 and 53 of the “Medical and Pharmacy Summary Plan Description” (“SPD”), latest version published January 1, 2008. You can access this “SPD” right here on our website. Go to the “Summary Plan Descriptions” box in the left column of our home page. Click on “Medical & Pharmacy SPD”. The document will open to the Table of Contents pages. Click on “Section 4: Tier I Actives Prescription Drug Benefits—the Schedule”, which will take you to pages 52 and 53 of this SPD.