Prescription Drugs Important Information
Important information about the full-time prescription drug plan:
- You automatically have prescription drug coverage when you enroll in a full-time medical plan.
- Copays and coinsurance for prescription medications will count toward the out-of-pocket maximum for Lowe’s medical plans.
- CVS Caremark administers the prescription drug program and offers a broad network of participating retail pharmacies including both national chains and independent retailers. Visit CVS Caremark’s website to locate a pharmacy near you. The Kaiser HMO plans offer coverage for prescription drugs through the Kaiser plan. Copays and coinsurance for prescription medications count toward the out-of-pocket maximum for Lowe’s medical plans but not your deductible for the Option 1 and Option 2 medical plans. For the Choice Account Plus and Choice Account medical plans, coinsurance for prescription medications count toward deductibles and out-of-pocket maximums.
- The plan provides coverage for generic, formulary brand-name drugs, and non-formulary brand-name medications. A formulary drug list is a list of medications made by most pharmaceutical manufacturers that are preferred by your plan. Preferred Generics and some preferred brands are available for a flat dollar copayment, and other drugs on the list are available for a coinsurance amount. To find out if a drug is on the formulary list, please visit the CVS Caremark website.
- Maintenance medications must be filled through the CVS Maintenance Choice plan, where participants receive a 90-day supply by mail or at a CVS Pharmacy at a discounted rate.
- You may want to consider trying an over-the-counter medication first. This may be more convenient and could save you money. Talk to your physician before making this decision. Over-the-counter drugs are not covered by the medical plan options.
- If you take injectable medications or specialty drugs to treat diseases like osteoporosis or some cancers, you will use CVS Caremark Specialty Pharmacy to receive your specialty medicines. In addition, Lowe’s is participating in the CVS Caremark Specialty Guideline Management Program. This program supports safe, clinically appropriate and cost-effective use of specialty medications. For questions, visit www.CVSCaremarkSpecialtyRx.com or call Specialty Customer Care toll-free at 1-800-237-2767 from 6:30 a.m. to 8 p.m. (CT) Monday through Friday.
- Select specialty medications will be covered only under the pharmacy benefit through CVS Caremark Specialty Pharmacy. These specialty medications will be not be covered under the medical plan. Check with your healthcare provider before having specialty drugs injected or infused. If you are a member of a medical plan option administered by BCBS of Alabama, you will need to confirm that they have an authorization from CVS Caremark. Healthcare providers are familiar with this process and perform such pre-authorizations routinely. Your healthcare provider should contact CVS Caremark and obtain the necessary authorizations before the treatment begins. To contact CVS Caremark, call 1-800-237-2767. This does not impact specialty medications currently dispensed through CVS Caremark Specialty Pharmacy.
Important Notice from Lowe’s Companies, Inc. About Your Prescription Drug Coverage and Medicare
Please read this notice carefully and keep it where you can find it. This notice has information about your current prescription drug coverage with Lowe’s Companies, Inc. and about your options under Medicare’s prescription drug coverage. This information can help you decide whether or not you want to join a Medicare drug plan. If you are considering joining, you should compare your current coverage, including which drugs are covered at what cost, with the coverage and costs of the plans offering Medicare prescription drug coverage in your area. Information about where you can get help to make decisions about your prescription drug coverage is at the end of this notice.
There are two important things you need to know about your current coverage and Medicare’s prescription drug coverage:
- Medicare prescription drug coverage became available in 2006 to everyone with Medicare. You can get this coverage if you join a Medicare Prescription Drug Plan or join a Medicare Advantage Plan (like an HMO or PPO) that offers prescription drug coverage. All Medicare drug plans provide at least a standard level of coverage set by Medicare. Some plans may also offer more coverage for a higher monthly premium.
- Lowe’s Companies, Inc. has determined that the prescription drug coverage offered by the Lowe’s Welfare Plan is, on average for all plan participants, expected to pay out as much as standard Medicare prescription drug coverage pays and is therefore considered Creditable Coverage. Because your existing coverage is Creditable Coverage, you can keep this coverage and not pay a higher premium (a penalty) if you later decide to join a Medicare drug plan.
When Can You Join A Medicare Drug Plan?
You can join a Medicare drug plan when you first become eligible for Medicare and each year from October 15th to December 7th.
However, if you lose your current creditable prescription drug coverage, through no fault of your own, you will also be eligible for a two (2) month Special Enrollment Period (SEP) to join a Medicare drug plan.
What Happens To Your Current Coverage If You Decide to Join A Medicare Drug Plan?
If you decide to join a Medicare drug plan, your current Lowe’s Companies, Inc. coverage will not be affected. Your current coverage pays for other health expenses in addition to prescription drugs. If you enroll in a Medicare prescription drug plan, you and your eligible dependents will still be eligible to receive all of your current health and prescription drug benefits through your Lowe’s enrollment (if applicable).
For further information on how your coverage will be affected, please review the Foundations for Success guide available on www.mylowesbenefits.com. The Foundations for Success guide offers an explanation of the prescription drug coverage plan provisions/options under the Group Medical Plan Options (except the Kaiser medical plan options) that Medicare-eligible individuals have available to them when they become eligible for Medicare Part D. Kaiser medical plan participants should refer to their Kaiser HMO Book and Certificate for information about their prescription drug benefits. You can also review the My Benefits website (www.mylowesbenefits.com) for a summary.
If you do decide to join a Medicare drug plan and drop your current Lowe’s Companies, Inc. coverage, be aware that you and your dependents will be able to get this coverage back if you are still actively employeed at Lowe’s.
When Will You Pay A Higher Premium (Penalty) To Join A Medicare Drug Plan?
You should also know that if you drop or lose your current coverage with Lowe’s Companies, Inc. and don’t join a Medicare drug plan within 63 continuous days after your current coverage ends, you may pay a higher premium (a penalty) to join a Medicare drug plan later.
If you go 63 continuous days or longer without creditable prescription drug coverage, your monthly premium may go up by at least 1% of the Medicare base beneficiary premium per month for every month that you did not have that coverage. For example, if you go nineteen months without creditable coverage, your premium may consistently be at least 19% higher than the Medicare base beneficiary premium. You may have to pay this higher premium (a penalty) as long as you have Medicare prescription drug coverage. In addition, you may have to wait until the following October to join.
For More Information About This Notice Or Your Current Prescription Drug Coverage
Contact the person listed below for further information. NOTE: You’ll get this notice each year. You will also get it before the next period you can join a Medicare drug plan, and if this coverage through Lowe’s Companies, Inc. changes. You also may request a copy of this notice at any time.
For More Information About Your Options Under Medicare Prescription Drug Coverage
More detailed information about Medicare plans that offer prescription drug coverage is in the “Medicare & You” handbook. You’ll get a copy of the handbook in the mail every year from Medicare. You may also be contacted directly by Medicare drug plans.
For more information about Medicare prescription drug coverage:
- Visit medicare.gov
- Call your State Health Insurance Assistance Program (see the inside back cover of your copy of the “Medicare & You” handbook for their telephone number) for personalized help
- Call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.
If you have limited income and resources, extra help paying for Medicare prescription drug coverage is available. For information about this extra help, visit Social Security on the web at www.socialsecurity.gov, or call them at 1-800-772-1213 (TTY 1-800-325-0778).
Keep this Creditable Coverage notice. If you decide to join one of the Medicare drug plans, you may be required to provide a copy of this notice when you join to show whether or not you have maintained creditable coverage and, therefore, whether or not you are required to pay a higher premium (a penalty).
Date: October 05, 2016
Name of Entity/Sender: Lowe’s Companies, Inc.
Contact–Position/Office: Lowe’s HR Shared Services
Address: Mail Code PRN6
1605 Curtis Bridge Road
Wilkesboro, NC 28697
Phone Number: 1-888-HRINFO5