2020 AtlantiCare Benefits Workbook

Prescription Drug

HOME TABL OF CONTENTS WELCOME.................2 WHAT’S NEW. ...........3 I E CENTERS AND WEBSITES...................4 HO TO ENROLL.......5 MEDICAL..............6-12 PRESCRIPTION DRUG. ................13-15 ADDITIONAL MEDICAL PLAN RESOURCES.........16-18 DENTAL...............19-21 VISION.....................22 LIFECENTER..............23 LIFE INSURANCE. .....24 LONG TERM DISABILITY...............25 VOLUNTARY OFFERINGS. ........26-29 SPENDING ACCOU TS. ............30 RETIREMENT BENEFITS..................31 WELLNESS. .........32-36 LEGAL NOTICES..37-39 CONTACTS.........40-41 GLOSSARY..........42-43 FAQs...................44-46 FORMS................47-56 WHAT’S NEW SERVICE CENTERS AND WEBSITES HOW TO ENROLL MEDICAL PRESCRIPTION DRUG ADDITIONAL MEDICAL PLAN RESOURCES DENTAL VISION LIFE INSURANCE LONG TERM DISABILITY VOLUNTARY OFFERINGS SPENDING ACCOUNTS RETIREMENT BENEFITS WELLNESS LEGAL NOTICES CONTACTS GLOSSARY

Retail Pharmacies (non-AtlantiCare) You can utilize your Geisinger prescription card to access retail pharmacies nationwide. While most large chains participate in the network, we do have some exclusions, such as Walgreens and Rite Aid. 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 formulary 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. To find a participating pharmacy or to see if your medication is covered, visit the Geisinger search tool at https://www.thehealthplan.com/atlanticare .

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 Geisinger Customer Service for assistance in obtaining your medication. Pharmacy Copays The maximum amount that you will pay for prescriptions per year: Single $1,750/Family $3,500.

? DID YOU KNOW? AtlantiCare pharmacy offers mail order service for all active employees and their dependents at no additional cost. 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 .

FORMS

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