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Benefits

FAQs - Medicare Carveout Prescription Coverage

Are there any exceptions to required participation in the UK Medicare prescription drug plan?

YES. If you are automatically enrolled into another Medicare Part D Plan by Medicare (for example, if you have full Medicaid coverage), you can continue to participate in the UK Medicare Advantage Plan for health plan coverage.

How can I get help with drug costs?

Resources are available for low-income households. Almost 1 in 3 people with Medicare will qualify for some financial help through Social Security’s Extra Help program. For those who meet certain income criteria, Medicare will pay for almost all prescription drug costs. You can apply or get more information about the Extra Help by calling Social Security at 1-800-772-1213 (TTY 1-800-325-0778) or visiting http://www.socialsecurity.gov/prescriptionhelp/ You may also contact the UK Employee Benefits’ Copay Counseling pharmacists at (859) 323-1493 for a free consultation and review of your medications. UK Elder Care counselors are also available at (859) 323-4600 to help you explore possible options for financial assistance through Medicare.

What is the prescription drug formulary?

A list of drugs that your UK Medicare Prescription Drug Plan covers is called a formulary. Your formulary lists covered medications along with levels of coverage and any restrictions such as prior authorization, step therapy, or quantity limits. Click here for the UK Medicare Prescription Drug Plan Formulary.

Are there any restrictions on which drugs may be prescribed?

To ensure medications are used in a safe and cost-effective manner, the UK Medicare Prescription Drug Plan may require "prior authorization" for certain drugs. This tends to be more common in situations where an equally effective drug may be available at a lower cost. This means before the plan will cover these prescriptions, prescribing health care professionals must first contact the plan. In some cases, specific drugs are available only as a part of a “step therapy” program, which first explores a series of different drug alternatives before more costly therapies are prescribed.

Can I get three months of a drug at a retail pharmacy?

YES. You can get a 90-day supply of a prescription drug at any retail pharmacy. However, you will receive a 90-day discount only through Express Scripts Home Delivery. The Kentucky Clinic Pharmacy is no longer able to provide the 90-day mail order discount. You must use Express Scripts home delivery.

Please note you WILL LOSE your UK health plan coverage through the UK Medicare Advantage Plan if you enroll in a separate Medicare prescription drug plan outside of UK. This means that if you drop your prescription benefit, you will not be able to have UK medical coverage.