As of January 1, 2023, prescription drug benefits are administered by CarelonRx. Prescriptions can be filled through your local retail pharmacy or by using the CarelonRx Mail Service Pharmacy.
Answer: If you use a retail pharmacy, your co-payments are $10.00 per 30-day supply for generic drugs, and $20.00 per 30-day supply for brand name drugs. If you use the mail order program, your co-payments are $20.00 per 90-day supply for generic drugs, and $40.00 per 90-day supply for brand name drugs. Please call the number on your ID Card for details.
Answer: Yes, some prescription drugs do require prior authorization from the Fund Office in order to be covered. Please refer to your Welfare Trust Fund Summary Plan Description for details.
Answer: Yes. You can continue to fill maintenance drug prescriptions (up to a 90-day supply) at your local pharmacy. Please remember that the plan has a mandatory maintenance drug policy that requires you to use the CarelonRx Mail Service Pharmacy. Maintenance drugs are those that will be taken over long periods of time (at least 90-days).
Answer: Yes. Please contact CarelonRx for a reimbursement form and mail it to the address shown on the form.
