YOUR DRUG BENEFITS Pharmacy services
Specialty pharmacy Medications for many chronic and complex health conditions can be hard to manage. Lumicera , our specialty pharmacy, works with you and your provider to help manage your condition and to make sure you receive the best care possible. We offer free delivery, same-day service, refill reminders, financial assistance and more. Have questions? Call 1 (255) 847-3553 . Drug formulary & management procedures We use a drug formulary, which is a list of prescription drugs that helps you understand what is and isn’t covered. Our drug formulary breaks the list into different tiers. The tiers are organized by the level of cost sharing between you and the health plan. The drug formulary is reviewed every month and updated on a regular basis. For example, we update the drug formulary when a new generic drug is approved. There are restrictions to and procedures for your coverage in order to help keep plan costs down. Restrictions to and procedures for your prescription coverage mean you may only receive drugs listed on our drug formulary (closed formulary). Certain drugs may have specialist restrictions or require you to visit a specialty pharmacy. You may also be required to have prior authorization, mandatory generic substitution, step therapy and quantity level limits for certain drugs. Be familiar with your plan’s specific coverage details and visit Deancare.com/Pharmacy to review our drug formulary, along with general limitations and procedures. Vaccine coverage Vaccines are covered and recommended for people of all ages. Doses and age-specific vaccines vary. Check with your doctor to ensure you and your family receive vaccines – including the flu vaccine – on time. As a health plan member with pharmacy benefits, you and your family can receive essential immunizations from your provider at your annual preventive care visits. Health plan members, ages six and older, can also get vaccines at in-network pharmacy locations. To find a pharmacy near you, visit Deancare.com/Pharmacy.
Convenience and member affordability are the name of the game when it comes to Dean Health Plan pharmacy services. We’re here to help you manage your prescriptions and lower your expenses.
SSM Health pharmacies + no-cost delivery Our friendly and professional staff are available at eight convenient locations. • Get answers to your questions and make sure your medications are right
• Refill prescriptions by phone or online • Get prescriptions filled for 90 days
Costco pharmacy Our preferred mail order pharmacy.
Interested in having your prescriptions delivered? You can order all your prescriptions through the Costco Pharmacy. A Costco membership is not needed to use their mail order pharmacy. To switch to Costco, members will need to register with Costco Mail Order Pharmacy. They can register by visiting Pharmacy.Costco.com and clicking “ Sign in/Register. ” You’ll also need your prescriber to submit new prescriptions to Costco. For more information about our Mail Order Pharmacy program, contact Member Services at 1 (800) 279-1301 ( TTY : 711) .
Visit DeanCare.com or call 1 (800) 279-1301 ( TTY : 711) | 17
16 | 2024 Group Member Guide
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