Prescription Drug Benefits
Your Employee Self Service
You can manage your information at home by logging into Employee Self Service through Remote Access.
You will automatically be provided with prescription drug coverage when you elect any of the medical plan options. For the NHRMC Plan and the Standard Plan, the rates shown in the chart below will apply to all prescription drug purchases. To obtain a listing of the participating pharmacies, generic equivalents and drug tier levels, go to www.MedImpact.com/.
2019 Medicare Part D Creditable Coverage Notice
- Your UnitedHealthcare membership card and identification number can also be used for prescription benefits. You will not receive a separate MedImpact prescription card.
- If you need to fill a prescription and you do not have your UnitedHealthcare card, provide the pharmacy the following information
- Prescription Benefit Administrator: MedImpact
- Rx Bin: 003585
- Rx PCN: ASPROD1
- Rx Group -- NHRMC: PHI23
Please feel free to contact the Benefits Team with any questions you may have. You can reach us by calling (910) 667-6000 or by dropping in to see us at the Business Center, Third Floor, Monday – Friday, 8 a.m. to 5 p.m.
For help finding a pharmacy or estimating the cost of your medications, you can visit www.MedImpact.com/.
NHRMC members can contact MedImpact at (888) 254-8850.
Mandatory Generic Drug Policy
Many prescription drugs are available as both a brand name drug and a generic name drug. By law, generic drugs must meet the same standards for safety and effectiveness as brand name
drugs. Obtaining generic drugs whenever possible can provide you with direct savings because you pay a lower co-pay. It also provides you with indirect savings because you save the plan money, which ultimately benefits you.
When you have a prescription filled, you will receive a generic substitute whenever possible. If there is not a generic equivalent available, tier pricing will apply. If you choose to receive the brand name drug and a generic equivalent is available, you will pay the difference between the full cost of the generic and the brand-name drug, plus the tier co-pay.
Prescription Drug Benefits
For answers to commonly asked questions about the Employee & Specialty Pharmacy, Maintenance Medications and Specialty Medications, please review this [FAQ].
Effective January 1, 2020*, employees and their covered dependents may use the Employee & Specialty Pharmacy or any Medimpact in-network retail pharmacy to fill their incidental prescriptions. Co-pays for 30-day prescriptions are:
•Tier 1 30‐Day Supply $4
•Tier 2 30‐Day Supply $20
•Tier 3 30‐Day Supply $40
*Prior to January 1, 2020, incidental prescriptions can be filled at any Medimpact in-network retail pharmacy.
Effective January 1, 2020**, all maintenance medications must be filled by the Employee & Specialty Pharmacy. Maintenance medications are drugs you take regularly to manage a chronic condition. The Plan allows you to fill a maintenance drug prescription two times for a 30-day supply at a retail pharmacy. If the drug needs to be filled for a third time, it is considered a maintenance drug and must be filled for a 90-supply. The Plan will not cover a maintenance drug prescription filled or refilled anywhere other than the Employee & Specialty Pharmacy. The employee or covered dependent will be responsible for the full cost of the medication.
Co-pays for 90-day maintenance drug prescriptions are:
•Tier 1 90‐Day Supply $10
•Tier 2 90‐Day Supply $50
•Tier 3 90‐Day Supply $100
Employees and their dependents have the choice of picking up their maintenance medications at the Employee & Specialty Pharmacy or having the medications shipped to their home address. Some restrictions will apply, notably controlled substances, so be sure to check with the Employee & Specialty Pharmacy.
**Prior to January 1, 2020, employees and their dependents must fill their maintenance drug prescriptions at Medimpact Direct or transition existing maintenance prescription from Medimpact Direct to the Employee & Specialty Pharmacy. Any new maintenance medication prescriptions that need to be filled after November 1, 2019 can be filled at the Employee & Specialty Pharmacy.
Currently, Medimpact Direct Specialty fills specialty medication prescriptions. Any new specialty medication prescriptions that need to be filled after November 1, 2019 may be submitted to the Employee & Specialty Pharmacy or Medimpact Direct Specialty. Effective January 1, 2020, specialty medications will only be filled by the Employee & Specialty Pharmacy.
A Note About the Formulary
In order to continue to offer highly affordable prescription drug benefits, we partner with MedImpact to encourage the use of affordable, safe and effective medications through our existing three-tiered plan. Our prescription drug formulary (also known as the preferred drug list) may reflect some changes during each year such as substituting some non-preferred brand name medications for generics or preferred brands; quantity limits; age restrictions; or step-therapy.
We work closely with MedImpact and our internal clinical team to ensure that these changes are safe, reasonable and provide effective alternatives. If you or a covered dependent are impacted formulary changes, you will receive a letter from MedImpact with information and instructions.
NHRMC Outpatient Pharmacy
You may purchase over-the-counter medicine at highly discounted rates, including ibuprofen, acetaminophen, antihistamine, cough medicine and smoking cessation aids.