Medicare Part D FAQ
Medicare Part D became effective Jan. 1, 2006, as a result of the Medicare Prescription
Drug, Improvement, and Modernization Act of 2003. Medicare Part D is a prescription
drug benefit provided by private insurance companies and other providers approved
by Medicare and contract with the federal government.
Who qualifies for Teamster Plus Medicare Part D Prescription Drug Program (PDP)?
You are eligible for membership in Teamster Plus Medicare Part D Prescription Drug Program (PDP) as long as:
- You are enrolled by your sponsoring employer/union in our Plan
- You are a Teamster retiree or spouse or dependent of a Teamster retiree
- You are entitled to Medicare Part A and/or you are enrolled in Medicare Part B.
What costs are covered under Teamster Plus Medicare Part D Prescription Drug Program (PDP)?
Teamster Plus Medicare Part D Prescription Drug Program (PDP) covers costs for drugs that are available only by prescription, approved by the Federal Drug Administration (FDA), used and sold in the United States for a medically-accepted condition, and are on our Formulary.
All drugs on Teamster Plus Medicare Part D Prescription Drug Program (PDP) are required to cover generic and brand-name prescription drugs, biological products, vaccines, insulin, necessary syringes, needles, alcohol swabs, and gauze. Teamster Plus Medicare Part D Prescription Drug Program (PDP) does not cover drugs for anorexia, weight loss/gain, ED, fertility, and cold/cough relief. Also, not covered are barbiturates, benzodiazepines, prescription vitamins, over-the-counter (OTC) medications, and cosmetics.
Where can I find general information about Medicare prescription drug coverage?
Please call Medicare at 1-800-MEDICARE/1-800-633-4227 (TTY/TDD users: 1-877-486-2048),
available 24/7. Or, visit Medicare.
Where can I get my prescriptions filled?
Teamster Plus Medicare Part D Prescription Drug Program (PDP) utilizes a network of participating pharmacies.
You must use a network pharmacy to receive plan benefits. To find out
if your pharmacy is in the network, call us toll-free at 1-866-412-7445 (TTY/TDD
users: 711), 8 a.m. to 8 p.m. in your local time zone or use our Pharmacy
Locator.
What is a network pharmacy?
A network pharmacy is a pharmacy where beneficiaries obtain prescription drug benefits provided by Teamster Plus Medicare Part D Prescription Drug Program (PDP). In most cases, your prescriptions are covered under our Plan only if you fill them
at a network pharmacy or through our mail order service. We will honor prescriptions at a non-network pharmacy under certain circumstances.
How do I fill a prescription at a network pharmacy?
You must show your Teamster Plus Medicare Part D Prescription Drug Program (PDP) Member ID card.
If you do not have your ID card with you when you fill your prescription, you may have
to pay the full cost of the prescription rather than paying just your copayment.
If this happens, you can ask us to reimburse you for our share of the cost by submitting
a claim to us. To find out how to submit a claim, look in your Evidence of Coverage
or call Customer Service.
How do I fill a prescription through the Teamster Plus Medicare Part D Prescription Drug Program (PDP) mail order pharmacy service?
To get order forms and information about filling your prescriptions by mail, please click on Useful Forms. Please note that you must use the Teamster Plus Medicare Part D Prescription Drug Program (PDP) mail order service. Prescription drugs that you get through any other mail order service are not covered.
Use the Teamster Plus Medicare Part D Prescription Drug Program (PDP) mail order service to fill prescriptions for 'maintenance drugs'. These are drugs that you take on a regular basis for a chronic or long-term medical condition. Our Formulary indicates which drugs we consider to be maintenance drugs. To use our mail order service, ask your doctor to write a new prescription for up to a 90-day supply of medication, plus refills as appropriate.
What if I need to fill a prescription while I am traveling,
and I am away from the plan's service area?
If you take a prescription drug on a regular basis and you are going on a trip,
be sure to check your supply of the drug before you leave. When possible, take along
all the medications you will need. You may be able to order your prescription drugs
ahead of time through our mail order pharmacy service.
Note: We cannot pay for any prescriptions that are filled by pharmacies
outside the United States and territories, even for a medical emergency.
What will I pay if I go to an out-of-network pharmacy for
one of the reasons listed above?
You will pay the full cost, rather than paying just your copayment when you fill
your prescription at an out-of-network pharmacy. You can ask us to reimburse you
for our share of the cost by submitting a claim form. If you go to an out-of-network
pharmacy, you may be responsible for paying the difference between what we would
pay for a prescription filled at an in-network pharmacy and what the out-of-network
pharmacy charged for your prescription.
When you go to a network pharmacy, your claim is automatically submitted to us by
the pharmacy. However, if you go to an out-of-network pharmacy because of the reasons
listed above, the pharmacy may not submit the claim directly to us, and you will
have to pay the full cost of your prescription. When you return home, submit the
Direct Member Reimbursement Form (Useful Forms) and your receipt to the following
address: MedImpact HealthCare Systems Inc, P.O. Box 509108, San Diego, CA 92150-9108. Upon receipt, we will make
an initial coverage determination on the claim. Please refer to your Evidence of
Coverage or call Customer Service for more information on initial coverage determinations.
If you have any questions about the availability of discounts for the drugs you
are taking, or about the Medicare Coverage Gap Discount Program, please contact Customer Service.
Where can I find more information about Teamster Plus Medicare Part D Prescription Drug Program (PDP)?
Refer to your Evidence of Coverage and other plan materials to find additional information about Teamster Plus Medicare Part D Prescription Drug Program (PDP). You can also contact Teamster Plus Medicare Part D Prescription Drug Program (PDP) Customer Service at 1-866-412-7445 (TTY/TDD users: 711), 8 a.m. to 8 p.m in your local time zone.
How do I end my membership in your plan?
Usually, to end your membership in our Plan, you simply enroll in another Medicare
Part D plan during an enrollment period. If you do not want to keep our Plan, you
can choose to enroll in another Medicare prescription drug plan or to drop your
Medicare prescription drug coverage. However, you should check with your Group Benefits
Administrator first.
If you would like to switch from our Plan to:
- Another Medicare prescription drug plan
Enroll in the new Medicare prescription drug plan. You will automatically be disenrolled
from our Plan when your new plan's coverage begins.
- A Medicare Advantage Plan
Enroll in the Medicare Advantage plan. With most Medicare Advantage plans, you will automatically be disenrolled from our Plan when your new plan's coverage begins. However, if you choose a Private Fee-For-Service plan without Part D drug coverage, a Medicare Medical Savings Account plan, or a Medicare Cost Plan, you can enroll in that new plan and keep our Plan for your drug coverage. If you want to leave our Plan, you can either enroll in another Medicare prescription drug plan or contact your employer/union, or our Teamster Plus Medicare Part D (PDP) Customer Service. Call us toll-free: 1-866-412-7445. Hearing-impaired callers using TTY/TDD equipment call toll-free: 711. Or, contact Medicare and ask to be disenrolled: 1-800-MEDICARE (1-800-633-4227). TTY users: 1-877-486-2048.
- Original Medicare without a separate Medicare prescription drug plan
Contact your employer/union Benefits Administrator or Teamster Plus Medicare Part D (PDP) Customer Service and ask to be disenrolled from the Plan. Call us toll-free: 1-866-412-7445. Hearing-impaired callers using TTY/TDD equipment call toll-free: 711. Or, contact Medicare and ask to be disenrolled: 1-800-MEDICARE (1-800-633-4227). TTY users: 1-877-486-2048.
Do I get a discount on prescription drugs?
Because Teamster Plus Medicare Part D Prescription Drug Program (PDP) has developed a network of pharmacies, you have access to discounted prices if you use the plan's pharmacy network. In addition, Teamster Plus Medicare Part D Prescription Drug Program (PDP) has a Union Designated Pharmacy network, which can save you even more money. Medicare Part D plans use various networks, so be sure to check if your preferred pharmacy is in the network.
If you want to see if your pharmacy is in our network, click here.