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Frequently Asked Questions
Pharmacy Benefit Overview
- What is Pharmacy Benefit Overview?
- Pharmacy Benefit Overview is a summary of your pharmacy benefit
as provided by your health plan's prescription drug program, managed
by Merck-Medco Rx Services. This at-a-glance overview shows when
to use a retail pharmacy, and when you should take advantage of
the convenience of mail service. Pharmacy Benefit Overview also
displays the days supply, copay, deductible and out-of-pocket
expenses associated when using your prescription benefit plan.
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- Why do I only see a tab called "Retail Pharmacy? I thought
I would see both retail and mail service pharmacy information."
- If you only see information about your retail plan benefit,
that means Merck-Medco only administers your retail prescription
benefit. If you have questions about your pharmacy benefit, please
contact your health plan sponsor.
- Why do I only see a tab called "Mail Service Pharmacy?" I
thought I would see both mail service pharmacy and retail pharmacy
information.
- If you only see information about your mail service pharmacy
benefit, that means that Merck-Medco only administers your mail
service prescription benefit. If you have questions about your
pharmacy benefit, please contact your health plan sponsor.
- How do I view the benefit information when both "Mail Service
Pharmacy" and "Retail Pharmacy" information is available?
- Simply select the "Mail Service Pharmacy" or "Retail Pharmacy"
tab to view the corresponding information.
- What does "Days Supply" mean?
- Days supply refers to the number of days of medication your
physician prescribes. In most cases, your physician will prescribe
a 30-day supply when using a retail pharmacy. For ongoing prescriptions,
you can tell your physician that you would like to use Merck-Medco's
mail service pharmacy and ask your physician to write your prescription
for the maximum days supply permitted by your plan. Note that
while each plan differs, most plans' maximum days supply when
taking advantage of mail service is 90 days.
- What is a copay?
- A copayment (copay) is the portion of the total cost of the
prescription that you must pay. Copayments differ depending on
your plan's coverage and guidelines and are necessary for new
prescriptions, prescription refills and prescription renewals.
- What is a deductible?
- A deductible is the amount of covered charges you must assume/pay before your
health plan provider will permit your insurance benefits to be paid.
- What is an out-of-pocket expense?
- The amount that a covered person must pay out of their own pocket, regardless
of one's coverage.
- Are there any differences in my benefits when using mail service
versus a retail pharmacy?
- If your benefit plan has a mail service component, having a larger
days supply, such as a 90-day supply when using mail service, increases
your convenience by shipping medications to your door and by providing
you the ability to use merck-medco.com to refill and renew your
prescriptions online, anytime, once you get started. Depending on
your plan's guidelines, taking advantage of your mail service benefit
could save you money. Check your plan's specifics for details.
- What if I've reviewed the information that you have displayed
in Pharmacy Benefit Overview and it seems to be different from what
I thought my benefit plan was?
- Always check your plan benefit materials should you need more
details or have questions. If you still need assistance, you
can send us an online
inquiry or call your
toll-free Member Services number for clarification.
Place
your own Refills/Renewals inquiry
© Copyright 1999 Merck-Medco Managed
Care, L.L.C. All Rights Reserved
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