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Benefits Plans - Prescription Drug Plan

Page last updated: Thursday, 24-Sep-2009 23:21:51 EDT

Introduction

The University of Michigan provides outpatient prescription drug coverage for faculty, staff, benefit-eligible graduate students, retirees, and their dependents enrolled in a U-M medical plan.

This site contains comprehensive information to help you understand the policies and procedures of the U-M Prescription Drug Plan, explaining how to obtain prescription medication under the plan, and providing information for physicians.

For changes to the drug plan, such as new drugs approved each month, view Drug Updates and New Releases.
To find co-pay costs for a drug, view Costs and Co-Pays.
To see if your prescribed medication is covered by the plan, view the U-M Formulary.
Certain drugs have quantity limits and/or require special approval before they can be purchased through the plan. For a list of these drugs, see Exclusions, Limitations, Prior Authorizations, Dose Optimization, Step Therapy, Self-Administered Injectable Medications.
For mail-order refills, go to the Walgreens Web site dedicated to U-M Prescription Drug Plan members: www.walgreensmail.com/umich.
To locate a network pharmacy near you, retrieve prescription drug co-pay estimates from any pharmacy within the informedRx/SXC network, and view your secure medication history profile, click here: https://umi.rxportal.sxc.com

Notice for Medicare-Eligible Retirees

In early 2006 Medicare began offering outpatient prescription drug coverage called Medicare Part D. After careful review of the new Medicare Part D Plan, the University of Michigan strongly urges Medicare-eligible active employees (and their dependents enrolled in the U-M plan) NOT to enroll in Medicare Part D plan. You do not have to do anything in order to retain your current prescription drug coverage in the University of Michigan plan.

The University advises that Medicare-eligible retirees and survivors as well as any Medicare-eligible faculty/staff on long-term-disability status (and their Medicare-eligible dependents enrolled in the U-M-plan) that think they may be eligible for Medicare low-income prescription drug financial assistance contact the Social Security Administration to determine if they should apply for low-income assistance and enroll in a Medicare Part D Plan, and continue their University medical plan. All others should not enroll in a Medicare Part D Plan.

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Overview of Plan Features

The Prescription Drug Plan provides coverage for FDA approved drugs prescribed by a physician, physician's assistant, or nurse practitioner up to a maximum of 90 days supply per fill, if your physician prescribes that amount.

The drug plan provides a consistent benefit and scope of coverage for all members. For example:

Psychiatric drugs, oral contraceptives and devices, and smoking cessation products are covered for all participants.
A convenient, secure mail order service administered by Walgreens offers delivery of a 90-day supply of medications to your home, office, or elsewhere in the United States.
A Web site dedicated to U-M Prescription Drug Plan members for mail order refills is available at www.walgreensmail.com/umich.

All eligible participants who enroll in University medical insurance plans—active employees, retirees, and dependents—are automatically enrolled in the University Prescription Drug Plan.

Pharmacy Benefit Manager

informedRx, an SXC company, administers the University of Michigan Prescription Drug Plan. Call informedRx/SXC Customer Service at 1-866-715-0874 (toll free) for prescription claim information or view the Web site at https://umi.rxportal.sxc.com.

Show Your informedRx/SXC ID Card When Filling Prescriptions

When your doctor writes a prescription for you, take it to a participating pharmacy and show the pharmacist your ID card from informedRx/SXC. The pharmacist will confirm your enrollment in the U-M Prescription Drug Plan and fill your prescription at the appropriate plan co-pay.

Overrides for supplies larger than 90 days needed for extended travel outside the U.S. may be arranged by contacting the Benefits Office.

Limitations
The University of Michigan in its sole discretion may modify, amend, or terminate the benefits provided with respect to any individual receiving benefits, including active employees, retirees, and their dependents. Although the university has elected to provide these benefits this year, no individual has a vested right to any of the benefits provided. Nothing in these materials gives any individual the right to continued benefits beyond the time the university modifies, amends, or terminates the benefit. Anyone seeking or accepting any of the benefits provided will be deemed to have accepted the terms of the benefits programs and the university's right to modify, amend or terminate them.

Every effort has been made to ensure the accuracy of the benefits information in this site. However, if any provision on the benefits plans is unclear or ambiguous, the Benefits Office reserves the right to interpret the plan and resolve the problem. If any inconsistency exists between this site and the written plans or contracts, the actual provisions of each benefit plan will govern. The University of Michigan in its sole discretion may modify, amend, or terminate the benefits provided with respect to any individual receiving benefits, including active employees, retirees, and their dependents.