Benefits Plans - Prescription Drug Plan: Drug Plan Updates and New Drug Releases -
FAQs — New Pharmacy Benefit Manager Effective October 1, 2012
Q: What is a Pharmacy Benefit Manager (PBM)?
A: Pharmacy benefits managers are companies that handle prescription drug claims processing, member and pharmacy customer services on behalf of the university. MedImpact HealthCare Systems, Inc. has been selected as the new PBM for the U-M Prescription Drug Plan.
Q: Why was MedImpact selected?
A: For several reasons, including better drug pricing at retail pharmacies, expected improved services, and more flexibility for the university to meet future needs.
Q: When will the change to MedImpact take place?
A: The change will occur on October 1, 2012. Until October 1, 2012 informedRx/SXC will continue to be your pharmacy benefit manager.
Q: What changes will affect me?
A: You will receive two new drug plan ID cards from MedImpact and must show the new ID card to your pharmacist the first time you or your covered dependent go to the pharmacy on or after October 1, 2012.
Q: How do I get a new drug plan ID card?
A: MedImpact will mail a “welcome packet” containing new ID cards to all U-M Prescription Drug Plan members in September.
Q: Do I need to take any action?
A: Just show your new MedImpact ID card to the pharmacist when you or your covered dependent have a prescription filled. The pharmacist can then verify your participation and bill your prescription to the U-M Prescription Drug Plan. If you wish to access the MedImpact member Web site to check your co-pay and see your drug history, register at www.medimpact.com/members.
Q: Will I have to pay more for my prescriptions?
A: No. The U-M Prescription Drug Plan drug benefits and co-pays remain the same.
Q: Can I continue using the same medications?
A: Yes. The drug coverage is not changing.
Q: Will my authorizations and approvals be transferred?
A: Yes. Current, active authorizations and approvals will be transferred.
Q: Will my mail order prescription be affected by this change?
A: No. NoviXus will continue as the mail order pharmacy for the University of Michigan Prescription Drug Plan.
Q: Didn’t the university just change to NoviXus for the drug plan last year?
A: Yes. NoviXus will continue providing mail order prescriptions for members of the U-M drug plan. NoviXus mail order provides lower out-of-pocket copays and home delivery for 90 day maintenance medications. The mail order service is not changing. Starting October 1, 2012 MedImpact will provide customer service to U-M drug plan members and will process your drug claims instead of informedRx/SXC.
Q: Can I use the same pharmacist and/or drug store I’ve been using to fill my prescriptions?
A: The MedImpact pharmacy network includes a nationwide network of 60,000 pharmacies. In most cases, you will be able to continue using the same pharmacy. Be sure to show your new University of Michigan / MedImpact drug plan ID card when filling a prescription.
Q: How do I determine if my local pharmacy is a MedImpact network pharmacy?
A: After October 1, the MedImpact pharmacy locator on the member website will help you find a participating network pharmacy in your area. You can also call MedImpact customer service for help finding a participating pharmacy. Starting October 1, 2012 call the MedImpact customer service dedicated line for U-M members at 800-681-9578.
Q: What if my local pharmacy is not a network pharmacy?
A: MedImpact has a large network of pharmacies all over the country. For the most convenient and lowest out-of-pocket cost, check the MedImpact pharmacy locator on the member website to find a participating pharmacy near you. If you have your prescription filled at a pharmacy that does not participate in the MedImpact network, you will have to pay the full cost of the drug and file a claim with MedImpact for reimbursement or transfer your prescription to a participating pharmacy. You will be reimbursed the amount that would have been paid to a participating pharmacy. Reimbursement claims must be filed within 90 days of fill.
Q: Where can I get up-to-date information on the U-M Prescription Drug Plan?
A: The most current information on all of the University of Michigan benefits can be found on the Benefits Office website: benefits.umich.edu
Q: My question wasn’t on this list, who can I call?
A: If you have a question regarding your prescription drug plan before October 1, call informedRx/SXC at 866-715-0874. Starting October 1, 2012 call the MedImpact customer service dedicated line for U-M members at 800-681-9578.
Q: What if I need to speak to someone regarding an issue with a pharmacy claim?
A: Until October 1, please contact customer service at informedRx/SXC regarding any prescription claim questions. SXC’s number is 866-715-0874. Beginning October 1, MedImpact’s customer service representatives will be available to assist you with prescription claims and pharmacy questions at 800-681-9578.
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.