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Exempt Retirees Pharmacy Services

Pharmacy Services

BNSF has contracted with Caremark to provide pharmacy services for the Aetna Network, CIGNA Indemnity and the Blue Cross Blue Shield BYO/PPO options. Caremark will provide you with an ID card.

Special note for retirees in the Aetna High Deductible Health Plan (HDHP). If you are enrolled in the Plan, Pharmacy services are provided through Aetna, rather than Caremark. You are responsible for cost of prescription needs until you satisfy the deductible. After the deductible is met, you will pay 20% of the cost of the medication until your out-of-pocket limit is met. Once you meet your out-of-pocket limit, medications are covered at 100%. You should always use an Aetna pharmacy to get the contracted rate for the medication and the in-network plan coinsurance noted above. If you do not use an Aetna network pharmacy, the plan will pay less and you may be subject to reasonable and customary charges.

Copayments

Under the Caremark provided pharmacy program, depending on the coverage you choose, you will pay either a copayment or coinsurance for the prescription drugs ordered by your doctor. The copayments for retail prescriptions you pay are:

  • $10 for generic drugs,
  • $25 for formulary brand name drugs, and
  • $40 for non-formulary brand name drugs

Mail Order (up to a 3-month supply), you pay:

  • $20 for generic drugs,
  • $50 for formulary brand name drugs, and
  • $80 for non-formulary brand drugs

Coinsurance

Under the coinsurance option when you choose the Build Your Own (BYO) health plan, for retail prescriptions you pay:

  • The greater of 25% coinsurance or
    • $10 for generic drugs
    • $25 for formulary brand name drugs, and
    • $40 for non-formulary brand name drugs
  • Your expense is limited to $100 per prescription
  • No deductible applies

Mail Order (up to a 3-month supply), you pay:

  • The greater of 25% coinsurance or
    • $20 for generic drugs
    • $50 for formulary brand name drugs, and
    • $80 for non-formulary brand name drugs
  • Your expense is limited to $200 per prescription
  • No deductible applies

Caremark determines what brand name drugs are in the formulary. Caremark maintains a guide for physicians when writing prescriptions. It includes the highest-quality and most cost-effective types of prescriptions available.

You can access the Preferred Drug List on the Caremark web site at www.caremark.com or by calling Caremark's customer service line at 1-800-378-7559.

More detailed information regarding pharmacy coverage is available in the Summary Plan Description of the medical option you are enrolled in.

Link to Summary Plan Descriptions (SPD)

Link to 2010 HDHP Preventive and Maintenance Prescription Drug List

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