Prescription Benefits
Orange & Rockland – Prescription Drug Program For O&R Retirees
(Administered by SilverScript for Medicare Enrolled Retirees)
(Administered by SilverScript for Medicare Enrolled Retirees)
SilverScript Facts
- SilverScript, an affiliate of CVS/Caremark, administers the prescription drug program for Medicare enrolled retirees.
- The O&R prescription plan supplements the Medicare Plan and Silver Script coordinates the processing of prescriptions through both plans.
- Over-the-counter drugs are not included in O&R’s plans. If you, your doctor, or hospital asks the pharmacy to submit an over-the-counter drug through O&R’s prescription plan, you will be responsible for the full cost of the drug. Please note that SilverScript will automatically send you a denial letter when a prescription for an over-the-counter drug is requested.
- For details of your Prescription Plan, please go to SilverScript’s website:
- O&R retirees: oruretirees.silverscript.com
- SilverScript’s Explanation of Benefits (EOB) reflects the CMS Medicare Standard Plan design, not your current plan through O&R. As a result, you will see the Medicare deductible on the statement. You are responsible for the deductible that the company sets for each plan year, which is different than the Medicare deductible. For example, if the Company prescription plan deductible is $100 per person and the Medicare deductible is $325, you would only be responsible for paying the Company plan deductible of $100.
- SilverScript processes all prescriptions through Medicare D first, but not all drugs are covered through Medicare D. If a prescription not covered by Medicare is denied, SilverScript will automatically process it through O&R’s supplemental prescription plans. The O&R prescription drug plans covers most legend drugs (drugs that cannot be dispensed without a prescription) and medicines that require a prescription from a doctor.
SilverScript Tips
- When using mail order, please consider the timeframe in which you need your medication. You should allow at least 2 weeks for processing a mail order prescription. If a pharmacist needs to contact your doctor for any reason, your prescription may be delayed beyond this 2-week timeframe. When prescriptions are needed in less than two weeks, bringing it to a CVS retail pharmacy may be your best option. Most prescriptions for long term medication can be filled at a CVS retail pharmacy.
- When using mail order or going to a retail pharmacy to fill your prescription, provide your correct contact number to allow the pharmacist to reach you with any questions, otherwise, your prescription may be delayed.
- Certain drugs are not covered through Medicare D. If you use the mail order program and Medicare D does not cover your prescription, SilverScript is required to send you an automatic denial notification. Before filing an appeal, call SilverScript at 1-855-702-1187 or log on to their website to see if the prescription is covered through the O&R supplemental prescription plan, in which case an appeal is not necessary.
- You can save time by setting up certain prescriptions on auto-renewal.
- In an emergency, you may request overnight delivery of medication at your own expense.
- If you have access to a computer, you can check the status of your prescriptions by using:
- Certain drugs need to be filled through the specialty pharmacy and pre-approval may be required.
- Before leaving the doctor’s office, please take the time to review your prescriptions.
PLEASE NOTE, THE COMPANY RESERVES THE RIGHT TO ALTER THE PROVISIONS OF THE MEDICAL COVERAGE AS IT IS DEEMED NECESSARY. SHOULD YOU CHANGE YOUR ADDRESS, PLEASE NOTIFY US IMMEDIATELY.
As a retiree covered under one of the health plans offered by Orange & Rockland Utilities, we are required to notify you of the privacy practices that will be followed by the companies and the health plans under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) to protect your personal health information (PHI). Privacy practices to protect your PHI went into effect on April 14, 2003 and continue to date.
The United States Department of Health and Human Services has issued final rules to implement statutory amendments under the Health Information Technology for Economic and Clinical Health (HITECH) and privacy protections for genetic information under the Genetic Information Nondiscrimination Act of 2008 (GINA).
Under the law and privacy practices, we have the responsibility to protect the privacy of your PHI by:
* Limiting who may see your PHI.
* Limiting how we may use or disclose your PHI.
* Explaining our legal duties and privacy practices.
* Adhering to these privacy practices.
* Informing you of your legal rights.
The Notice of Privacy Practices describes how we will comply with the law and your legal rights. If you have any questions or would like a printed version of this Notice, you may contact the HR Service Center at 1-800-577-9527.
As a retiree covered under one of the health plans offered by Orange & Rockland Utilities, we are required to notify you of the privacy practices that will be followed by the companies and the health plans under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) to protect your personal health information (PHI). Privacy practices to protect your PHI went into effect on April 14, 2003 and continue to date.
The United States Department of Health and Human Services has issued final rules to implement statutory amendments under the Health Information Technology for Economic and Clinical Health (HITECH) and privacy protections for genetic information under the Genetic Information Nondiscrimination Act of 2008 (GINA).
Under the law and privacy practices, we have the responsibility to protect the privacy of your PHI by:
* Limiting who may see your PHI.
* Limiting how we may use or disclose your PHI.
* Explaining our legal duties and privacy practices.
* Adhering to these privacy practices.
* Informing you of your legal rights.
The Notice of Privacy Practices describes how we will comply with the law and your legal rights. If you have any questions or would like a printed version of this Notice, you may contact the HR Service Center at 1-800-577-9527.