Straight TeleTalk: Medications Matter
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Judy:
Hello, everyone, and welcome to the SCAN health plan TeleTalk.
My name is Judy Velarde and I'm a Senior Advocate at SCAN. And that means that I'm a member just like you are but I also work part time for SCAN. Let's see; I've been a member for about four years now and a Senior Advocate for a little over three. Now, I think SCAN has fantastic benefits but the one that I use the most is the prescription benefit. Now, I take a very expensive medicine for my eyes and I was curious if I didn't have SCAN how much would this medicine cost. So I called about three pharmacies and I found out it was $200 a month for a 30-day supply.
Doug:
Wow.
Judy:
So yeah, so I'm so happy to be on SCAN because I pay a third of that and that certainly helps on income.
But today I'm here to host this TeleTalk and it basically means that I need to make sure we get time for some of your questions. So let me go ahead and introduce the other two people with me today.
Sharon Jhawar is the Chief Pharmacy Officer at SCAN. Hi, Sharon. Say hello to everybody.
Sharon:
Hi, everyone. As Judy mentioned, I'm Chief Pharmacy Officer here at SCAN and by way of background I am a pharmacist and my specialty training was in caring for seniors. I've been with SCAN for about 14 years now and I ensure that the prescription drug benefit that we provide is comprehensive, affordable and in alignment with Medicare rules. In addition, I also oversee a variety of pharmacy programs, which aim to help each of you get the most out of your medications.
Judy:
Thanks, Sharon.
Now our other speaker today is Doug Buseck and Doug is – let's see if I get this right, Doug. Doug is a Process Improvement Manager in our healthcare services support department. Quite a title!
Doug:
You got it exactly right. Hello, everybody. I've been here at SCAN almost 20 years and in healthcare services, I do process improvement. I mostly work behind the scenes to try to make things work for all of our members and our employees and basically to make things better.
Judy:
Great. Now that we've introduced ourselves, let's go ahead again and get started. Now, Doug, I'm going to hand this over to you.
Doug:
Okay, thank you, Judy. And I'd like to start by thanking the listeners for taking part in this TeleTalk. At SCAN, we know how important medications are to your health and what a difference they can make in the quality of life for those of you who have chronic health conditions. We want SCAN members to enjoy life, to stay healthy and independent. A key piece to this is taking medications as prescribed. So we'll be talking to Sharon about things you can do that will make it easier to take your medications.
Sharon, why do so many of us find it difficult to take our medications as we should?
Sharon:
You know, Doug, we all have good intentions about taking our medications as prescribed. But in our day-to-day lives, things come up. Some of the reasons some of us forget to take our medication may be because we forget to order a refill or pick up our medication on time from the pharmacy. Some of us have challenges paying for our medications, while some of us may experience a side effect we don't like. So we either skip a dose or altogether stop taking our medication.
Doug:
Wow, that makes a lot of sense and for folks who take several medications each day, I know prescription costs can sure add up fast. Sharon, what are some of the ways that our members can save money on their medications?
Sharon:
I have four tips that I'd recommend to help lower your prescription costs. First, is taking generic medications if they're available. We are very fortunate right now to live in a world of generic medications and generics are much more affordable than brand drugs. In fact 90 percent of all of our prescriptions filled by our members are actually for generic.
Doug:
Oh, wow
Sharon:
Yeah, so if you happen to be on a brand-name drug and you want to lower your prescription, ask either your doctor or pharmacist if there's a generic substitute
Doug:
Okay.
Sharon:
Secondly, if you're stable on chronic medications and you're filling them each month, you may want to consider switching to a 90-day supply because your co-pays are lower when you fill 90 days.
Doug:
I see.
Sharon:
A third tip is around making sure you use a Preferred pharmacy as your copays these pharmacies are lower. And we'll talk a little bit more about Preferred pharmacies later.
Lastly you may want to see if you qualify for Extra Help. Extra Help is a federal program offered by Medicare for people with either a limited income or resources who need some help paying for their medications. And eligibility for the program is based off of income as well as asset level. To see if you might qualify, you can call My Advocate at 1-866-866-0871. Once again, that number is 1-866-866-0871 or simply call SCAN Member Services and we can help to connect you.
Doug:
Oh, yeah. Well, you know, what? We have our first listener question coming in. Josie just wrote in to say she would like to know more about a 90-day supply and we were definitely going to tell you more about that. But thank you for the question, Josie.
Sharon, can you tell everyone listening why our motto here at SCAN is “Just Say 90-Day?”
Sharon:
Yeah. So Just Say 90-Day is important to remember because, Doug, studies actually show the simple act of filling a 90-day supply, actually helps us to stay on track with our medications and taking them regularly and in turn that just keeps us healthy.
Doug:
Nice. Sharon, how does a 90 day supply of prescriptions help the members save money?
Sharon:
Yeah, we want to positively encourage our members to make good decisions about their health. Because we know when our members fill a 90-day supply, it will keep their health on track. We actually provide copay savings for 90-day prescriptions. Whether you use a retail or home delivery pharmacy, you can say when filling a 90-day supply. We provide a three-month supply for only two copays for Tier 1 and Tier 2 medications and a $10 discount off of a three-month supply for Tiers 3 and 4 medications. And on average, Doug, SCAN members taking three or more medications can save up to a $115 per year by switching to a 90-day supply. That's a great saving.
Doug:
So just by switching, they can save that much money?
Sharon:
Yeah.
Doug:
Nice, nice. What about the members who qualify for that program you talked about, that Extra Help program from Medicare to pay for the prescription drugs. Will they save money?
Sharon:
Great question. For those who actually qualify for Extra Help, you should also remember our mantra of Just Say 90-Day. Our savings opportunity is even greater for folks that are on Extra Help; after all, when you're on Extra Help, it's the exact same copay regardless of whether you're filling a 30 or 90-day supply. And so what that means is, if you're filling a 30-day supply today, you could be saving on copays by filling a 90-day supply.
Doug:
Mm. Wow, and I remember the mantra because Judy walks around the halls here at SCAN saying it all the time, right?
Judy:
And we have posters all over.
Doug:
So there's a lot of reasons to choose a 90-day supply for ongoing medications. Let me see if I got this right: It's easier, more convenient than making regular trips to the pharmacy and it saves you money.
Sharon:
Yep.
Doug:
Okay. Sharon, what are some of the things we can all do to remember to take our medications?
Sharon:
Forgetfulness is a challenge that we all face with taking our medications. Some tips to help remember to take your medications include things like establishing a routine that works for you. So, if for example, you take a medication in the morning, maybe keeping it right by your toothbrush to take each morning as a useful reminder.
Doug:
Oh.
Sharon:
Yeah, using a pillbox can help tremendously if you're on several drugs. There are many types of pill boxes to select from depending upon your medication schedule and. Another really helpful tool is setting an alarm for when it's time to take your medications. A lot of us travel and so planning in advance and making sure you take enough medication is important as well.
Doug:
Yeah, I've forgotten to take some of mine with me on a business trip.
Judy:
Whew, not good.
Doug:
Not good. All those things you mentioned, Sharon, are pretty easy and they're common sense things that we can do to help remember to take our meds. What are some other ways, especially for listeners who have to keep track of several prescriptions each week?
In my case, I asked for my pharmacy to send me a text message to my phone when the refills are ready for me to pick up. I find it's really an easy way to be reminded that I'm about to run out of the prescription and I need to make time to get to the drugstore. Are there others?
Sharon:
Yeah, you know, that's a great example, Doug. And I would really recommend utilizing the pharmacy to help each of our members stay on track with their medication. You can sign up for a pharmacy’s auto-refill or refill reminder program through your local pharmacy. And it just reminds you when it's time for your next refill. All you have to do is simply mention it the next time you're at the pharmacy counter, that you'd like to sign up for the program.
Doug:
Wow, that's easy.
Sharon:
Yeah. In addition, many of our members who use smartphones, I would also encourage you to download Express Scripts mobile app, which can be downloaded through either iTunes or Google Play. It's absolutely free and what I like about it is that you can use it to set an alarm to remind you to take your medications. Also, you can also use it to check on when you're running low for your medication you actually need to order refills. So it also provides you with a medication help fill history as well. If you actually use Express Scripts Home Delivery, you can order those refills right there on the app.
Doug:
It’s sure handy.
This seems to be a good time to talk about another way to save, which is SCANS Preferred and Standard pharmacies. We talked a little bit about that at the beginning but can you walk us through that in more detail? What is the difference between a Preferred and a Standard pharmacy?
Sharon:
Yeah, so as a SCAN member, you have access to over 65,000 pharmacies nationwide and each pharmacy has a designation of being either Preferred or Standard. For most SCAN plans, you can get a Tier 1 medication for a $0 copay at a Preferred pharmacy. In addition, your medications on Tiers 2, 3 and 4 have nearly a $5 lower copay than a Standard pharmacy. So by using a Preferred pharmacy, you save on your prescription drug cost.
Doug:
I see. You know, right now for those of you joining us with your computers on your screen, you'll see a list of our Preferred and Standard pharmacies. There are a lot more pharmacies that will appear here but the main ones are listed there for you to know. Let me read through them for everyone. The preferred pharmacies include:
- Albertsons
- Costco
- Express Scripts Home Delivery
- Rite Aid
- Walgreens
- Walmart
- And select independent pharmacies
And what I mean by an independent pharmacy is within SCANS broad pharmacy network. We have pharmacies for the major chains and we also have pharmacies that are not part of those large chains but we call them our select independent pharmacies because they're really good too. As far as our Standard pharmacy list goes, we have:
- CVS
- Medicine Shoppe
- Ralph's
- Target
- And other select independent pharmacies
Judy:
Doug and Sharon, we do have another question from one of our members.
Doug:
Hey!
Judy:
Yeah, Audrey just wrote that she's on a new medication and it has some side effects and she wants to know what she can do about them? Doug, you want to answer that?
Doug:
Sure, sure, yeah. I've been on some medications that have left me feeling pretty lousy and I'll be honest: I was tempted to stop taking them. But as we've been saying today, it is really important to take your medications in order to stay healthy. Sharon, what are some of the things Audrey can do if her medications are making her feel bad?
Sharon:
Yeah, so if any member is experiencing side effects with a medication, I'd recommend either talking with their doctor or pharmacist with the specifics around what they're experiencing to help determine if the side effects may actually lessen with time, which may be the case with some medications or whether it's worthwhile to change your prescription to something that you'll tolerate better.
Doug:
Let's get back to some of the challenges our members face when taking medications and transportation is a challenge for some people. Sharon, what are some of the things that can help our members who need to get their prescriptions but cannot get to the pharmacy on their own?
Sharon:
Now, many of our plans that we offer here at SCAN have a transportation benefit that can be used to get to the pharmacy. Another perk of filling a 90-day, which we've been talking a lot about today is that it saves the number of trips to the pharmacy that you have to make.
Doug:
Oh, yeah.
Sharon:
Yeah, another option to consider is home delivery. We partner with Express Scripts for home delivery and so if anyone's interested in signing up, you can reach Express Scripts at 1-866-553-4125. Once again, that number is 1-866-553-4125. And delivery’s free and the medications are delivered directly to your home so that's a nice service as well.
Another option that a lot of folks are not aware of is something called “medication synchronization.” And, really, what that means is that at your local pharmacy, they can align the timing of refills for most of your medications that you take on an ongoing basis so that you can pick them up all at once at the same time.
Doug:
That's great.
Sharon:
Yeah, so to get more information about that, just ask the next time you're at your pharmacy counter that you're interested in that type of program.
Judy:
Great! Thank you, Sharon and Doug. You know we've covered so much ground and I really feel like this is a subject we could talk about for the rest of the day. But you know we should stop to take some questions from our listeners and thank you to everyone who's been listening today and also for sending us your questions.
I've got one from Dale and he's asking, “How do I change pharmacies if I want to switch over to a Preferred pharmacy?”
Sharon:
Yeah, so it's really easy to switch over to a Preferred pharmacy. Just bring in your prescription bottles that have refills to the new pharmacy you'd like to use. The pharmacy actually does all the work for you and transfers the prescriptions right over.
Doug:
Nice. Thanks, Sharon.
Oh here's another good question. If there's one thing we want listeners to take away from our TeleTalk today, it's signing up for the 90-day supply of medication. So Laura in West Covina wants to know “How do I change my prescriptions to a 90-day supply?”
Sharon:
Hm. Good question. So simply ask your pharmacy to dispense a 90-day supply. They may need to reach out to your doctors to get an updated prescription. Or the next time you see your doctor, ask him or her to give you a new prescription for a 90-day supply.
Judy:
Okay, so let’s go ahead and take some more questions for our listeners
Doug:
Yeah, yeah.
Sharon:
Alright I have several that I'll go through. One is from Victoria: “How do 90-day prescriptions work with the donut hole?” So that's a good question. Yep, for a majority of our plans, we offer additional coverage in the donut hole for most generic medications. So you'll still be able to get a 90-day supply for your regular copay for generics.
Doug:
Okay.
Sharon:
Mary has a Formulary question and it is “What is a copayment for the shingles shot?” So the name of the shingles shot is Zostavax.
Doug:
Easy for you to say!
Sharon:
Yeah. And remember, it is a Tier 4 copay. Now, depending upon what plan you're on, the actual copayment does change a little bit. So, Mary, if you want to take a look at your Formulary to get the exact copay for the plan that you're in.
Doug:
Can I take one? I got one. No, take a question – I’m not volunteering for these prescriptions! Leland in Culver City asks, “How can I sign up for a refill reminder or the auto-refill program at my pharmacy?” You mentioned that earlier, Sharon. Is it easy to sign up for auto-refill or…?
Sharon:
Auto-refill. Yeah, the next time you're in the pharmacy, just ask at the pharmacy counter and the technician or pharmacist that's helping you can set you up with that.
Doug:
Awesome, thank you. Thanks for letting me run with one.
Judy:
Yeah, threw me off, Doug! I thought you wanted to take medication!
Sharon:
Alright, another question that's come in from Barry. Let's see. “There are some medications for which I can't get a 90-day supply. Why can't I get them for a 90-day supply?”
Doug:
Oh.
Sharon:
So there are some medications on our Formulary, which have a quantity limit or some medications that are not considered chronic medications for which a 90-day supply is appropriate. So you can always call Member Services to find out if your medication has a quantity limit or you can search online through our Formulary.
Doug:
Okay, that's a good question.
Sharon:
Elvia has a question, “I was told that I can get Metformin for a 30-day supply. Is this true?”
So Metformin is a chronic medication and you can either get a 30-day as well as a 90-day. So you can't – maybe she's asking, “I can only get it for a 30-day” and the answer would be, no, you are able to get a 90-day for this medication. Because, you know, you're taking it regularly for your diabetes and so that's probably misinformation. I would highly recommend getting a prescription for a 90-day supply.
Doug:
Is the idea that it's a chronic situation and that usually makes the drugs available for 90 days?
Sharon:
Yeah, with diabetes, you know, you want to maintain your blood sugar and as long as Elvia’s stabilized on the medication, she would be set to fill a 90-day supply if she wanted to.
Doug:
That sounds good. I think Judy has a question.
Judy:
I got a question! Yay! Now, Donna is writing in that she didn't hear her current pharmacy on our list of pharmacies that we talked about a few minutes ago. So, Sharon, how do members find out if their pharmacy is a Preferred or a Standard?
Sharon:
Yeah, a quick way to do that is to check on line at www.scanhealthplan.com and click on “Find Provider and Drugs.” Or you can also call Member Services at 1-800-559-3500. Once again, our Member Services number is 1-800-559-3500.
Doug:
And what are those numbers again?
Sharon:
Our Member Services is 1-800-559-3500.
Doug:
Thank you.
Judy:
Okay. Well, you know, that's about all the questions we have time for today. And if you have a question that we didn't answer or maybe you think of something later, please remember Member Services is available until 8 p.m. tonight. And I will tell you that Member Services is typically busiest in the mornings and at the beginning of the week. So if your call can wait, you may try calling later in the week or even in the evening. Now, the phone number is on the back of your SCAN ID card and it's also on the screen but I'll go ahead and give you that number now. It's 1-800-559-3500. And don't forget that you can also email member services and, again, the email address will appear on your screen but, again, I’ll give that email address to you. The email address for Member Services is memberservices@scanhealthplan.com. And be sure to visit our website for more information about your benefits and it's a great way to review our prescription Formulary. And it's another easy web address to remember. It's www.scanhealthplan.com.
I want to thank all of you for joining us today and especially for choosing SCAN as your health plan. And I hope everybody has a great afternoon.
Doug:
Bye-bye, everybody.
Sharon:
Bye.
Judy:
Bye.