2023 AtlantiCare Benefits Booklet

Prescription Drug

TABLE OF CONTENTS WELCOME.................2 WHAT’S NEW. ...........3 SERVICE CENTERS AND WEBSITES..........4 HOW TO ENROLL....5-6 MEDICAL..............7-14 PRESCRIPTION DRUG. ................15-17 ADDITIONAL MEDICAL PLAN RESOURCES........18-22 DENTAL...............23-24 VISION.....................25 LIFECENTER..............26 LIFE INSURANCE. .....27 DISABILITY...............28 VOLUNTARY OFFERINGS. ........29-32 SPENDING ACCOUNTS. ............33 RETIREMENT BENEFITS..................34 WELLNESS. .........35-38 LEGAL NOTICES...39-41 GLOSSARY..........42-43 FAQs...................44-46 CONTACTS.........47-48 FORMS................49-58

Retail Pharmacies (non-AtlantiCare) You can utilize your MedImpact prescription card to access retail pharmacies nationwide. While most large chains participate in the network, we do have some exclusions. To find a participating pharmacy, or to see if your medication is covered, visit the MedImpact Member portal at https://www.medimpact.com/web/login When you utilize these pharmacies, please consider the following: • Your copay may be higher than what you would pay at your AtlantiCare Pharmacy. • If your medications are not categorized as generic or preferred brand, you may be responsible for the full cost of the prescription. • Any medication obtained from a non-AtlantiCare Pharmacy will only be filled for up to a 30-day supply (90-day supply not available). • Maintenance medications can only be refilled one time at a non-AtlantiCare pharmacy. • AtlantiCare pharmacy offers mail order service for all active employees and their dependents at no additional cost.

Specialty Medications AtlantiCare Pharmacy will process your specialty medications. Please note, specialty medications may require prior authorization, so please plan accordingly. If the AtlantiCare Pharmacy is unable to fill your request, they will direct you to contact MedImpact Customer Service for assistance in obtaining your medication.

? DID YOU KNOW

Members can request ID cards via MedImpact Customer Service ( 1-833-229-3595 ) and have the option to print a temporary ID card from the member website by logging onto www.medimpact.com until their new ID card is mailed to them.

Medications are delivered within 2-3 days. Mail order forms can be found on the HR Portal: Benefits tab on The Starfish or by calling the Galloway pharmacy at 609-404-7444 .

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