Transition Plan effective July 1, 2013
The Transition Plan is limited to enrollees transferring from a state-run PCIP in Arkansas, California, Colorado, Iowa, Illinois, Kansas, Michigan, Missouri, New Hampshire,
New York, North Carolina, Ohio, Oregon, Pennsylvania, South Dakota, Utah and Washington.
Effective July 1, 2013, the coinsurance will be 30%, and the out-of-pocket maximum will be $3,125, or $5,000 for non-formulary prescriptions, for the Transition Plan.
To learn more about these changes, click Plan Materials and download the 2013 PCIP Brochure.
Prescription drug refill change
At the beginning of the 2013 plan year, PCIP only covered formulary and generic prescription drugs from a retail
pharmacy the first two times you had them filled. The third fill and after had to be filled through mail order. That
is no longer required. Effective February 15, 2013, you can get your formulary and generic prescription drugs at a
retail pharmacy even after the first two fills. On the third fill and after for both formulary and generic prescriptions,
you will pay the standard coinsurance or 50%, whichever is greater. To avoid the possibility of a greater coinsurance,
check out the mail-order options available at (800) 427-6145. The coinsurance will count toward your prescription drug
deductible and out-of-pocket limit, regardless if you get them filled at a retail pharmacy or through Express Scripts/Medco,
our mail-order pharmacy. Please see our 2013 PCIP Brochure [PDF download]
or call us at (800) 220-7898 if you have questions.
The Health Insurance Marketplace
Starting next year, the Affordable Care Act guarantees that all Americans – regardless of their health status or pre-existing conditions – will finally
have access to quality, affordable coverage. People will be able to apply for affordable health insurance coverage choices in Health Insurance Marketplaces
when open enrollment begins on October 1. The Health Insurance Marketplace will offer a choice of quality, affordable health plans. Coverage begins on January 1, 2014.
Visit www.healthcare.gov to learn more about the Marketplace.
Health assessment: Complete yours within 90 days
Your assessment will help us learn about your health needs and how we can
best help you. The simple online questionnaire identifies your health risks and
needs as you transition to PCIP coverage. To get started, just click Health Assessment.