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Benefits 101: New Prescription Drug Programs from Medco

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As we prepare to begin a new calendar year and a new benefit plan year in January, Lehigh University medical insurance subscribers will have access to two additional support programs from Medco. These offerings could result in cost savings, helpful advice, and more services for you from Lehigh’s prescription drug provider.

The Generics RxAdvantage Program

The Generics RxAdvantage Program (GRxA) provides potential co-payment waivers for members as well as resources for learning about generic drugs and savings opportunities. Specifically, GRxA will provide benefits for those who sign up for the program, including:

  • Copayment waivers for a three-month supply of new generic prescriptions at the Medco Pharmacy (mail order)
  • Copayment waivers (up to $25) for select brand prescriptions that will soon become generic, when these prescriptions are moved from a retail pharmacy to the Medco Pharmacy
  • Online tools and customer service support to assist you in understanding your generic savings opportunities
  • Ongoing communications to help you learn about and take advantage of generic savings opportunities as they become available.

What Does This Mean For You?

The GRxA program may or may not benefit you depending on your situation. If you have brand name prescriptions for which a generic is available or may become available soon, you might realize cost savings. There are some restrictions and some brand names for which this benefit is not offered.

The best approach is to sign up for the program at the Medco website beginning January 1, 2012, and then check into which of your prescriptions might qualify.
GRxA will be an ongoing program. Once you’ve signed up, you will be eligible for copayment waivers as they become available.

Medco HealthStage Patient Engagement

In an effort to communicate to members more effectively, Medco has been closely examining its prescription claim data. After analyzing its vast database of patients, Medco recently identified four “health stages” that best describe most of its current members who use prescription drugs regularly:

  • Newly Chronic (17 percent): Patients who have recently been diagnosed with a chronic condition and are starting to use long-term medications for the first time
  • Maintaining Health (55 percent): Patients who have been taking long-term medications for an extended period of time, with no change in therapy, dose, or condition
  • Changing Therapy (11 percent): Patients whose therapy is changing in terms of dosage or drugs being used to treat their chronic condition
  • Adding Conditions (17 percent): Patients diagnosed with a new chronic condition when they already have one or more chronic conditions.

After determining these categories, Medco then gained insight into the needs of each segment through consumer research. The result is a plan to communicate with each group of patients in a unique way to fulfill their varied needs and wants.


What Does This Mean For You?

If you rarely use your prescription drug benefit, you won’t likely see a change. If, however, your situation fits one of the four described above, you will receive enhanced communication from Medco.

For instance, Medco will reach out to patients who are new to a category and mainly using retail pharmacies, because such patients might benefit from using the Medco Pharmacy.  In addition, communications from Medco will be tailored to the needs of each segment. 

More Resources Online

Regardless of your current situation, we recommend that you visit the Medco website and create an account. In addition to giving you access to your prescription drug orders and claim statuses, your Medco account lets you purchase non-prescription items from the Medco Health Store. Once you are logged in, you can also gain access to special health resource centers on the Medco website.

To register at Medco.com, you will need your member ID number. This is your Lehigh Identification Number (LIN), which can be obtained by logging into Banner on the Campus Portal.

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