Trust PPO Plan Prescription Coverage
Retail, mail order and specialty pharmacy benefits for you and your family.
Find a network pharmacy on the MedImpact website or call the Pharmacy Helpdesk at (800) 788-2949 for more information.
The Washington Teamsters Welfare Trust offers comprehensive prescription coverage to Plan participants. MedImpact administers PPO plan prescription coverage and provides a nationwide network of pharmacies and the Birdi mail order service.
Prescription drug benefits are not subject to the medical plan deductible, and the reimbursement level doesn’t change when your medical plan coinsurance out-of-pocket maximum is satisfied. There are out-of-pocket maximums for medical plans A,B and Z, after which there is no longer a co-pay amount for the remainder of the year. The out-of-pocket maximum is reviewed every year and can be found in your Medical Plan Summary of Benefits and Coverage (SBC). Medical plan JC28XL does not have a limit.
Find a Pharmacy
A list of the network pharmacies is available on the MedImpact website or by calling the Pharmacy Helpdesk at (800) 788-2949 for more information.
Retail Pharmacy Benefits
Your retail pharmacy benefit depends on whether the prescription drug is a brand name or generic and whether you buy your prescription drugs at a MedImpact network pharmacy. You pay only your share of the cost to the pharmacy when you purchase your prescription. The Plan then pays the balance of the cost directly to the pharmacy. If you have questions about a prescription you can look it up in MedImpact’s formulary list or call the MedImpact Pharmacy Helpdesk at (800) 788-2949.
Except in medical emergencies, only prescriptions purchased at a MedImpact network pharmacy are covered by the Plan.
Medical Plans A, B and Z
| Type of Drug | Recommended Network Pharmacy, you pay: | Regular Network Pharmacy, you pay: | Non-Network Pharmacy (medical emergency only), you pay: |
|---|---|---|---|
| Generic | 10% of the drug cost | 15% of the drug cost | $9 handling fee in addition to your normal cost share |
| Formulary Brand (preferred) | 30% of the drug cost | 35% of the drug cost | $9 handling fee in addition to your normal cost share |
| Non-formulary Brand (non-preferred) | 40% of the drug cost | 45% of the drug cost | $9 handling fee in addition to your normal cost share |
Medical Plan JC28XL
Please refer to your plan booklet to see your specific prescription coverage or log in to www.nwadmin.com to see the details of your plan.
Mail Order Pharmacy Benefits
Birdi™ is MedImpact’s mail order and specialty pharmacy service for the Trust PPO Medical Plan. You can save time and often money by using Birdi for your prescriptions.
When you use Birdi mail order, you pay only the co-pay amount and, in many cases, can get a larger supply of your medication (up to 100 days).
Medical Plans A, B and Z
| Generic | Formulary Brand (preferred) | Non-Formulary Brand (not preferred) |
|---|---|---|
| You pay 10% of the drug cost or up to a maximum $15 co-pay per prescription | You pay 30% of the drug cost or up to a maximum $90 co-pay per prescription | You pay 40% of the drug cost or up to a maximum $130 co-pay per prescription |
To transfer a prescription to mail order or get help getting a prescription filled, visit MedImpact to login and get started or call Birdi at (855) 873-8739.
Medical Plan JC28XL
Please refer to your plan booklet to see your specific prescription coverage or log in to www.nwadmin.com to see the details of your plan.
Specialty Pharmacy Benefits
The Plan offers a specialty prescription drug program that covers medications used to treat certain health conditions that include:
Crohn’s disease
Growth hormone deficiency
Hepatitis C
HIV/AIDS
Multiple sclerosis
Psoriasis
Rheumatoid arthritis
Prescription medications covered under the specialty prescription drug program may change from time to time.
You can order many specialty prescription drugs through the Plan’s Mail Order pharmacy, which can save you money. You can get a 100-day supply for 10% of the drug cost or $15 co-pay (whichever is less) on generic drugs, or 30% of the drug cost or $90 co-pay per prescription for brand-name drugs. Ancillary supplies, such as syringes and alcohol swabs are included with your order at no charge. Your medication will be delivered to your home or doctor’s office at no cost to you.
If you have questions about the specialty prescription drug program or need to refill a prescription, call MedImpact Direct at (855) 873-8739.
Plan Limits
Please note that prescription drug benefits are not subject to the medical plan deductible, and the reimbursement level doesn’t change when your medical plan coinsurance out-of-pocket maximum is satisfied. There are out-of-pocket maximums for medical plans A, B and Z, after which there is no longer a co-pay amount for the remainder of the year. The out-of-pocket maximum is reviewed every year and can be found in your Medical Plan Summary of Benefits and Coverage (SBC) under Plan Information.
Medical plan JC28XL does not have a limit.