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Plan DocumentPharmacy_files/Health%20Plan%20Summary.pdf
Catalyst Rx Sitehttp://www.catalystrx.com
 


Administered by CatamaranRx

Calendar Year Deductible

Per Covered Person   $50

Per Family                $100


Co-payment per Prescription

(Prescriptions are limited to a 34-day supply per prescription)


Medical Center Pharmacy

Generic Prescription  $10

Brand Preferred Prescription - Greater of $25 or 20% (max of $100)

Brand Non-Preferred Prescription - Greater of $40 or 20% (max of $100)


Prescription Drug Pharmacy

Generic Prescription  $15

Brand Preferred Prescription - Greater of $30 or 25% (max of $100)

Brand Non-Preferred Prescription - Greater of $45 or 25% (max of $100)

Pharmacy Coverage

Pharmacy coverage thru SGMC’s Health plan is administered by Catalyst Rx.  When you have your prescriptions filled at SGMC’s Medical Center Pharmacy, the Plan is designed to pay at a higher rate.  The Medical Center Pharmacy is located off of Woodrow Wilson Drive at 2202 Flemming Street, Valdosta.

Generics for $4

The Medical Center Pharmacy offers certain generic drugs for $4 for 30-day supply and $10 for a 90-day supply. Click Here to see the listing of $4 Generics.


Medicare Creditable Coverage Notice

South Georgia Medical Center has determined that the prescription drug covered offered by the South Georgia Health System (Third Party Administrator – UMR) 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 SGMC’s 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.  For more information about Medicare prescription drug coverage call 1-800-MEDICARE (1-800-633-4227) or visit www.medicare.gov.


Children’s Health Insurance Program (CHIP)


If you are eligible for coverage from your employer, but are unable to afford the premiums, you may be eligible for premium assistance programs that can help you pay for coverage. If you or your dependents are NOT currently enrolled in Medicaid or CHIP, and you think you or any of your dependents might be eligible for either of these programs, you can contact your State Medicaid or CHIP office or dial 1-877-KIDS NOW or www.insurekidsnow.gov to find out how to apply.

Preferred Drugs

To determine whether a brand drug is Preferred or Non-Preferred, visit the CatamaranRx Website at www.catalystrx.com, or call Catalyst Rx Customer Service at 1-888-727-5560. Catalyst Rx Customer Service is available 24 hours a day 7 days a week.