STATE HEALTH BENEFITS
PROGRAM (SHBP)
RETIREE PRESCRIPTION DRUG COPAYMENTS
(NJ DIRECT10 and NJ DIRECT15 PLANS)
STATE AND LOCAL GOVERNMENT RETIREE COPAYMENT AMOUNTS
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Education Retiree Copayments
Plan Year 2011
prescription drug
copayments for Retired Group State Health Benefits Program
(SHBP) members enrolled in NJ DIRECT10 or
NJ DIRECT15.
Effective January
1, 2011, Medco Health Solutions, Inc.
will administer prescription drug benefits for the
SHBP.
RETAIL PHARMACY COPAYMENT AMOUNTS
Up to a 90-day Supply
| Supply |
Generic |
Preferred Brand |
All Other Brands |
|
01-30 days
|
$10
|
$22
|
$44
|
|
31-60 days
|
$20
|
$44
|
$88
|
|
61-90 days
|
$30
|
$66
|
$132
|
MAIL ORDER COPAYMENT AMOUNTS
Up to a 90-day Supply
| Supply |
Generic |
Preferred Brand |
All Other Brands
|
| 01-90
days |
$11 |
$33 |
$55 |
MAXIMUM OUT-OF-POCKET AMOUNT
Effective January
2011, there is an annual maximum out-of-pocket amount for
prescription drug copayments of $1,351 per person.
Once a person has paid $1,351 in copayments in a calendar
year, that person is no longer required to pay any prescription
drug copayments for the remainder of that calendar year.
Prescription drug copayments
are not eligible for further reimbursement and do not apply
to medical plan deductibles or coinsurance.
If you have any questions
regarding this information, contact the Office of Client Services
at
(609) 292-7524 or send an e-mail using the "contact us" link
below.
|
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