Prescription Coverage
All Modine medical plan options include prescription coverage through CVS/Caremark. The cost for your prescription drugs depends on the formulary tier it is in:
- Preventive: Covered at 100% to treat chronic conditions such as high cholesterol and high blood pressure
- Generic: Have the same active ingredients as the brand-name
- Formulary: On the list of covered drugs but cost more than generics
- Non-Formulary: On the list of covered drugs but cost more than formulary
- Specialty: Used to manage chronic or genetic diseases, including injectables or oral medications, or require special handling
Contact Information
| Blue PPO Plan 1 | Blue PPO Plan 2 | Blue HDHP 3 | |
|---|---|---|---|
| Retail Prescription Drugs (30-day supply) | |||
| Generic | 20% Coinsurance$10 Minimum Copay/$20 Maximum Copay | Preventive Drugs: Covered 100%*All Others: Deductible, then 20% Coinsurance (no copay) | |
| Formulary | 30% Coinsurance$20 Minimum Copay/$60 Maximum Copay | ||
| Non-Formulary | 40% Coinsurance$40 Minimum Copay/$120 Maximum Copay | ||
| PrudentRx Specialty Prescription Drugs** | |||
| 30% CoinsuranceNo Minimum/No Maximum | Preventive Drugs: Covered 100%*All Others: Deductible, then 20% Coinsurance (no copay) | ||
| Mail Order (90-day supply) | |||
| Generic | 20% Coinsurance$25 Minimum Copay/$50 Maximum Copay | Preventive Drugs: Covered 100%*All Others: Deductible, then 20% Coinsurance (no copay) | |
| Formulary | 30% Coinsurance$50 Minimum Copay/$150 Maximum Copay | ||
| Non-Formulary | 40% Coinsurance$100 Minimum Copay/$200 Maximum Copay | ||
**For more details, call CVS/Caremark Specialty Customer Service at 800.237.2767, visit caremark.com, or refer to the PrudentRx Specialty Drug List.
Prescription Drug Programs
CVS Maintenance Choice® Program
Maintenance Choice offers you options and savings when it comes to filling prescriptions.
CVS Caremark Mail Service Pharmacy:
- Enjoy convenient, reliable delivery to the location of your choice
- Receive your medications in unmarked, tamper-resistant and (when needed) temperature controlled packaging
- Talk to a pharmacist by phone toll-free, 24/7, from the privacy of your home
CVS/Pharmacy:
- Pick up your medication at a time that is convenient for you
- Enjoy same-day prescription availability
- Talk with a pharmacist face-to-face
The Maintenance Choice® Program also includes Kroger affiliated pharmacies, Costco Pharmacy and its mail pharmacies, and several independent pharmacies, in addition to CVS Pharmacy and CVS Caremark® Mail Service.
PrudentRx Copay Program
If you enroll in a PPO medical plan, the PrudentRx Copay Optimization Program allows you to fill certain specialty medications at no cost to you. That means $0 out of pocket for select specialty drugs when you fill by CVS Specialty and enroll in the PrudentRx program. If you opt out or choose not to participate, those select specialty drugs will be subject to a 30% coinsurance. To enroll, call PrudentRx at 800.578.4403.
Preventive Drugs Under the Blue HDHP 3 Plan
Many preventive drugs are covered 100%, at no cost to you, when you use an in-network pharmacy and are enrolled in the Blue HDHP 3 Plan. Preventive drugs are those designated as preventive on the High Deductible Health Plan — Health Savings Account Preventive Therapy Drug List and on the CVS/Caremark Advanced Control Formulary Drug List.