Presbyterian Health Plan | Summer 2019 | Your Story

www.phs.org 7 Presbyterian’s translation and interpretation services Communication is important to you and to us. That’s why we offer translation services if you need them. We want you to have the information in the language or format you use so you can take charge of your own healthcare. We have bilingual staff and certified translator services. These services are available to help you talk with providers, nurses, and caregivers; learn about your health plan; and much more. Our translation and interpreter services include: • Language translation • Written materials translation • Telephonic interpreters • In-person interpreters • American Sign Language interpreters • Video remote interpreters It’s easy to request these services. Ask for them at any of Presbyterian’s clinics or hospitals. You can also call the Presbyterian Customer Service Center at the number on your member ID card. Four-tier drug plans Most members have a four-tier drug plan. Each tier has a different copayment or coinsurance. This is the cost-sharing amount you pay. See your Schedule of Benefits for your copayment amounts. Your copayments are lowest for Tier 1 (preferred generic) and Tier 2 (preferred brand-name) drugs. Your copayments are higher for Tier 3 (non-preferred) drugs. Tier 4 drugs are self-administered specialty pharmaceuticals. Specialty pharmaceuticals are medications for people that have serious, chronic, or rare health conditions. These medications are high cost, often require special storage and handling, and need to be taken on a very strict schedule. You must get these drugs from a chosen specialty pharmacy network. Your provider may need a prior authorization before these drugs are covered. Will mail service save youmoney? Based on your prescription drug plan and on the drug you take, you may save money using the mail-order service. Mail-order service can also help you maintain a regular supply of important maintenance medications used for chronic conditions like high cholesterol, high blood pressure, asthma, diabetes, or depression so you don’t run out. Contact the Presbyterian Customer Service Center at the number on your member ID card for the mail- order pharmacy contact information. Presbyterian partners with OptumRx to provide prescription mail-order/home delivery services. Check your benefit plan materials for details. To set up a mail-order account with OptumRx, call their customer service center at 1-866-528-5829 (24 hours a day/7 days a week). They will help you transfer prescriptions and set up payment. After you set up a mail-order account, you can order refills online. Login to myPRES and select “Access MyPharmacy” to find the “My Medicine Cabinet” home page. Please note, the first time you follow these steps you will be asked to register with OptumRx for a Healthsafe ID. Presbyterian partners with OptumRx to provide pharmacy benefits information. Future visits will be faster. Note: Self-administered specialty drugs (Tier 4) and schedule II narcotics are not available through mail order. Other drug plans Some benefit plans use a more limited drug list than the Formulary. Also, some employers may customize the drug coverage they offer. Look in your member materials for information about your prescription benefits. You may also call the Presbyterian Customer Service Center at the phone number on your member ID card to speak with someone who can help you. If you prefer to conduct your own search, go to www.phs.org/mypres and “Access MyPharmacy” to find information about your health plan benefits and more.