[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-283923-105":3,"detail-sidebar-cat-1-en-105":81,"doc-detail-283923-en":127},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","outpatient-prescription-drug-program-addendum-for-2006-how-to-use-this-plan","OUTPATIENT PRESCRIPTION DRUG PROGRAM ADDENDUM FOR 2006 - How to Use This Plan","","Outpatient Prescription Drug Program addendum effective July 1, 2006, detailing how Medco administers outpatient drug benefits for PERS Choice/PERSCare. The addendum explains eligibility and dispensing requirements, coverage management programs and clinical drug utilization review, and how benefits are accessed through the nationwide retail pharmacy program or Medco mail-order (Medco By Mail). It also outlines copayment incentives for generic, Preferred, and Non-Preferred medications, grace-period rules when formulary status changes, and guidance for preferred formulary lookup and member responsibilities.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/template/","Template",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/template/forms/","Forms",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/template/outpatient-prescription-drug-program-addendum-for-2006-how-to-use-this-plan/283923/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/outpatient-prescription-drug-program-addendum-for-2006-how-to-use-this-plan/283923.png","ImageObject",442,249,{"name":42,"@type":43},"Valentina","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-22","2026-09-17",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",9,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"Who administers the outpatient prescription drug program starting July 1, 2006?","Question",{"text":63,"@type":64},"Medco administers the Outpatient Prescription Drug Program beginning July 1, 2006 under the PERS Choice/PERSCare plan addendum.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"How can covered outpatient prescription drugs be obtained?",{"text":68,"@type":64},"Covered drugs may be obtained through the Medco Retail Pharmacy Program or the Medco Mail-Order Program (Medco By Mail), subject to the program exclusions and coverage management approvals.",{"name":70,"@type":61,"acceptedAnswer":71},"What happens if a brand-name drug is no longer on the Preferred Drug List?",{"text":72,"@type":64},"Members have a 3-month grace period starting July 1, 2006 and pay the Preferred brand-name copayment during that time; after the grace period ends on October 1, 2006, the higher non-Preferred brand-name copayment applies.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},283923,1790153524,{"code":4,"msg":82,"data":83},"success",[84,89,94,99,104,109,113,118,123],{"id":85,"doc_module":22,"doc_module_name":25,"category_name":86,"show_sort_weight":87,"slug":88},11,"Presentations",90,"presentations",{"id":90,"doc_module":22,"doc_module_name":25,"category_name":91,"show_sort_weight":92,"slug":93},12,"Resumes",80,"resumes",{"id":95,"doc_module":22,"doc_module_name":25,"category_name":96,"show_sort_weight":97,"slug":98},14,"Invoices",70,"invoices",{"id":100,"doc_module":22,"doc_module_name":25,"category_name":101,"show_sort_weight":102,"slug":103},15,"Posters",60,"posters",{"id":105,"doc_module":22,"doc_module_name":25,"category_name":106,"show_sort_weight":107,"slug":108},16,"Social Media",50,"social-media",{"id":110,"doc_module":22,"doc_module_name":25,"category_name":29,"show_sort_weight":111,"slug":112},17,40,"forms",{"id":114,"doc_module":22,"doc_module_name":25,"category_name":115,"show_sort_weight":116,"slug":117},18,"Letters",30,"letters",{"id":119,"doc_module":22,"doc_module_name":25,"category_name":120,"show_sort_weight":121,"slug":122},21,"Paper Templates",5,"papers-templates",{"id":124,"doc_module":22,"doc_module_name":25,"category_name":125,"show_sort_weight":4,"slug":126},158,"General","general-158",{"code":4,"msg":82,"data":128},{"doc_id":79,"user_id":129,"nickname":42,"user_avatar":130,"doc_module":22,"category_id":110,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":131,"file_id":132,"file_url":133,"file_type":134,"file_size":135,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":105,"language":136,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":137,"faqs":138,"seo_title":139,"seo_description":12,"update_tm":140,"read_time":141},13056703020460,"https://ap-avatar.wpscdn.com/avatar/be000253dac470eee5d?_k=1778207105932848923","OUTPATIENT PRESCRIPTION DRUG PROGRAM ADDENDUM FOR 2006  \nTABLE OF CONTENTS  \nHOW TO USE THIS PLAN .........................................................................................................................1  \nOutpatient Prescription Drug Benefits ......................................................................................1  \nCopayment Structure...................................................................................................................1  \nRetail Pharmacy Program ...........................................................................................................3  \nHow To Use The Retail Pharmacy Program Nationwide..........................................................3  \nMail-Order Program .....................................................................................................................5  \nHow To Use Medco By Mail ........................................................................................................5  \nPRESCRIPTION DRUG COVERAGE MANAGEMENT PROGRAMS ......................................................7  \nOUTPATIENT PRESCRIPTION DRUG EXCLUSIONS .............................................................................9  \nPRESCRIPTION DRUG APPEAL PROCEDURE....................................................................................11  \nDEFINITIONS ...........................................................................................................................................13  \nPERS Choice/PERSCare Plan  \nThis addendum contains complete information on the PERS Choice/PERSCare Outpatient Prescription Drug Program incorporating Medco as the prescription drug benefit administrator beginning July 1, 2006. Please put this important information with your 2006 Evidence of Coverage (EOC) booklet for future reference.  \nThis addendum supersedes the Outpatient Prescription Drug Program information in the Evidence of Coverage. All references to page numbers refer to pages in this addendum. The meanings of key terms used in this addendum can be found in the Definitions section of this addendum (pages 13 and 14) and in the Definitions section of the Evidence of Coverage.  \nHOW TO REACH US –  \nFor information regarding the Retail Pharmacy Program or Mail-Order Program effective July 1, 2006, you may call or visit on-line:  \nMedco Health Solutions, Inc.  \n1-800-939-7091  \n1-800-497-4641 (outside the continental U.S. )  \nWeb site: [www.medco.com](www.medco.com)  \nHOW TO USE THIS PLAN  \nOutpatient Prescription Drug Benefits  \nThe Outpatient Prescription Drug Program is administered by Medco. This program will pay for prescription medications which are: (a) prescribed by a licensed physician in connection with a covered illness or accidental injury; (b) dispensed by a registered pharmacist, subject to the exclusions listed in the Outpatient Prescription Drug Exclusions section of this addendum; and (c) approved through the Coverage Management Programs described in the Prescription Drug Coverage Management Programs section of this addendum. All prescription medications are subject to clinical drug utilization review when dispensed.  \nCovered outpatient prescription drugs prescribed by a licensed physician in connection with a covered illness or accidental injury and dispensed by a registered pharmacist may be obtained either through the Medco Retail Pharmacy Program or the Medco Mail-Order Program, Medco By Mail.  \nThe Plan’s Outpatient Prescription Drug Program is designed to save you and the Plan money without compromising safety and effectiveness standards by encouraging you to ask your physician to prescribe generic drugs whenever possible and to also prescribe medications on Medco’s Preferred Drug List. Members can still receive any covered medication, and your physician still maintains the choice of medication prescribed.  \nCoordination of Benefits provisions do not apply to the Outpatient Prescription Drug Program. Copayment Str","cbCaidbOeJTd4cgG","https://ap.wps.com/l/cbCaidbOeJTd4cgG","pdf",235822,"English","# HOW TO REACH US\n## Retail Pharmacy Program and Mail-Order Program\n# HOW TO USE THIS PLAN\n## Outpatient Prescription Drug Benefits\n## Copayment Structure\n## Retail Pharmacy Program\n## How To Use The Retail Pharmacy Program Nationwide\n## Mail-Order Program\n## How To Use Medco By Mail\n# PRESCRIPTION DRUG COVERAGE MANAGEMENT PROGRAMS\n# OUTPATIENT PRESCRIPTION DRUG EXCLUSIONS\n# PRESCRIPTION DRUG APPEAL PROCEDURE\n# DEFINITIONS","[{\"question\":\"Who administers the outpatient prescription drug program starting July 1, 2006?\",\"answer\":\"Medco administers the Outpatient Prescription Drug Program beginning July 1, 2006 under the PERS Choice/PERSCare plan addendum.\"},{\"question\":\"How can covered outpatient prescription drugs be obtained?\",\"answer\":\"Covered drugs may be obtained through the Medco Retail Pharmacy Program or the Medco Mail-Order Program (Medco By Mail), subject to the program exclusions and coverage management approvals.\"},{\"question\":\"What happens if a brand-name drug is no longer on the Preferred Drug List?\",\"answer\":\"Members have a 3-month grace period starting July 1, 2006 and pay the Preferred brand-name copayment during that time; after the grace period ends on October 1, 2006, the higher non-Preferred brand-name copayment applies.\"}]","OUTPATIENT PRESCRIPTION DRUG PROGRAM ADDENDUM FOR 2006 - How to Use This Plan | PDF",1789622538,6]