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• In 2006, we processed more than 89 million mail order Rx’s. • Medco employs over 16k. 6,200 of those are union members.
• Clients include BCBS plans, large employers, health plans, and state and local government clients
• August 2007 – Medco purchases PolyMedica
• August 2005 – Medco purchases Accredo nation's largest specialty/biotech pharmacy operation
• We have pharmacies in Columbus and Cincinnati, Ohio. Also in Pittsburgh, Tampa, and Dallas. Automated pharmacies in Las Vegas, and Willingboro, NJ. Specialty pharmacy in Memphis. Opening a new automated pharmacy in Indiana.
Maintenance drugs are those drugs taken on an on-going basis (3 months or more). Examples – medicines to treat high blood pressure, diabetes or high cholesterol.
If a drug is on the Mandatory Mail Drug List, the prescription can be filled 3 times at their retail pharmacy.
On the 4th fill, the prescription must be filled through Medco By Mail to avoid paying the full cost of the drug at retail
Member receives a reminder letter after the 2nd fill at a retail pharmacy
Coverage Review Process(In Order to Receive the Brand-name Drug at the Brand Co-pay)
If currently taking a brand-name drug when a generic version is available, the member will receive a letter from Medco Health encouraging them to discuss with their doctor the reasons why they need to take the brand-name drug.
If the doctor believes that there are clinical reasons for the member to take the brand-name drug, they should ask their doctor to contact Medco Health at 1 800-841-5409 to initiate
Value – To bring greater patient safety by protecting against potentially dangerous dosing that does not meet FDA-approved guidelines or national physician best practice guidelines
Definitions: Prior authorization (PA): Medication not covered unless
approval obtained through coverage review. 1 800-417-1764. Step therapy (ST): Part of PA process, may include use of
preferred products as first step/therapy requirement Quantity limit (QL): Allows for a certain number of pills or
tablets for use for a certain amount of time
The review uses plan rules based on FDA-approved prescribing and safety information, clinical guidelines, and uses that are considered reasonable, safe, and effective
BCBSM Ford Service Center: For questions about the Prescription Drug Program, such as benefits, co-pays, and eligibility, Actives call 1-800-482-5146, Retirees/Surviving Spouses call 1-800-426-4610
Medco: For questions about your Medco By Mail prescriptions, such as order status, account balances, or when and how an order was shipped, call 1-800-778-0735