EXPRESS SCRIPTS MEDICARE RETIREE PRESCRIPTION PLAN

Note for May 13-29, 2013 Open Enrollment: State of Delaware Pensioners, spouses and dependents enrolled in Medicare Part A and Part B for primary medical coverage and also eligible for or enrolled in the Highmark Delaware Special Medicfill Medicare Supplement plan, DO NOT make changes in Special Medicfill coverage until a separate Open Enrollment period available in October 2013 for calendar year 2014.

Beginning January 1, 2013, Medicare-eligible retirees and Medicare-eligible dependents of retirees who wish to receive prescription drug benefits through the GHIP are offered the opportunity to participate in the only prescription drug plan available through the GHIP for Medicare-eligible retirees – the employer-sponsored enhanced Medicare Part D Prescription Drug Plan called Express Scripts Medicare (PDP) for the State of Delaware.

Coverage through another Medicare Part D prescription drug plan is not allowed if you wish to retain your coverage through the Express Scripts Medicare PDP for the State of Delaware. If you enroll in a Medicare prescription drug plan, other than the Express Scripts Medicare PDP for the State of Delaware, prescription drug coverage through the State of Delaware for you and your eligible dependents will terminate.

Going forward, the following members will be offered enrollment in the new Express Scripts Medicare plan:

• New retirees who are enrolled in Medicare A and B plus Special Medicfill with Prescription Coverage upon retirement.
• Medicare-eligible spouses or dependents of new retirees.
• Retirees or their dependents who become eligible for Medicare A and B due to age or disability.

Retirees and/or their dependents must enroll in Medicare A and B when eligible due to age or disability, and a signed copy of the Medicare card must be submitted to the Office of Pensions or to the non-State participating group's benefits office prior to enrollment in the Highmark Delaware Special Medicfill with Prescription Coverage Plan.

When the enrollment is submitted, members will first receive a pre-notification letter from Express Scripts, and they will receive new identification cards in the Welcome Kit a few weeks later.

Please click on the topics below for additional information.

• Benefit Overview
   
• Frequently Asked Questions (FAQ's)
   
• Copy of Information Meeting Presentation Slides
   
• DIRECT CLAIM FORM FOR EXPRESS SCRIPTS MEDICARE – You may print copies of this form for use when a pharmacy requires that you pay out of pocket for a prescription for one of the following reasons:
  • The pharmacy is a non-participating pharmacy.
  • You have other coverage that is primary, and this is a coordination of benefits claim.
  Please be sure to read the form carefully, check the appropriate reason for using a non-participating pharmacy, complete all requested information and include all receipts. Please remember to keep a copy for your records.

Last Updated: Monday April 22 2013