Prescription Drug Benefits
If you’re eligible for Medicare, you will be automatically enrolled in SilverScript, a division of the CVS Health drug program. SilverScript will issue you a personal ID card. If you have questions or concerns about SilverScript or your enrollment, please contact them directly at 1-855-702-1187.
If you are not Medicare-eligible, you will receive an ID card from CVS Health and your coverage will continue under the “commercial” CVS Health plan.
|
Retirees Under Age 65 or Non-Medicare Eligible |
Prescription |
Retail |
Preferred Network and Mail 90‐Day Supply |
|---|---|---|---|
|
Retirees Under Age 65 or Non-Medicare Eligible |
Prescription Annual Deductible |
Retail $150 |
Preferred Network and Mail 90‐Day Supply None |
|
Retirees Under Age 65 or Non-Medicare Eligible |
Prescription Annual Out-Of-Pocket Maximum |
Retail None |
Preferred Network and Mail 90‐Day Supply None |
|
Retirees Under Age 65 or Non-Medicare Eligible |
Copays |
Generic Drugs (A) |
Preferred Brand Drugs (B) |
NonPreferred Brand Drugs (C) |
|---|---|---|---|---|
|
Retirees Under Age 65 or Non-Medicare Eligible |
Copays 30-Day Supply (any network pharmacy*) |
Generic Drugs (A) $15 |
Preferred Brand Drugs (B) $40 |
NonPreferred Brand Drugs (C) $60 |
|
Retirees Under Age 65 or Non-Medicare Eligible |
Copays 90-Day Supply (Mail and Preferred Network Pharmacy**) |
Generic Drugs (A) $35 |
Preferred Brand Drugs (B) $90 |
NonPreferred Brand Drugs (C) $135 |
SilverScript Plan Highlights
|
Retirees Over 65 or Under 65 and on Medicare |
Prescription |
Retail |
Preferred Network and Mail 90‐Day Supply |
|---|---|---|---|
|
Retirees Over 65 or Under 65 and on Medicare |
Prescription Annual Deductible |
Retail $150 |
Preferred Network and Mail 90‐Day Supply None |
|
Retirees Over 65 or Under 65 and on Medicare |
Prescription Annual Out-Of-Pocket Maximum |
Retail None |
Preferred Network and Mail 90‐Day Supply None |
|
Retirees Over 65 or Under 65 and on Medicare |
Copays |
Standard Network Retail* |
Preferred Network Retail** |
Mail Order |
|---|---|---|---|---|
|
Retirees Over 65 or Under 65 and on Medicare |
Copays Generic Drugs (A) |
Standard Network Retail* |
Preferred Network Retail** |
Mail Order |
|
Retirees Over 65 or Under 65 and on Medicare |
Copays 30-Day Supply |
Standard Network Retail* $15 |
Preferred Network Retail** $15 |
Mail Order $35 |
|
Retirees Over 65 or Under 65 and on Medicare |
Copays 60-Day Supply |
Standard Network Retail* $30 |
Preferred Network Retail** $30 |
Mail Order $35 |
|
Retirees Over 65 or Under 65 and on Medicare |
Copays 90-Day Supply |
Standard Network Retail* $35 |
Preferred Network Retail** $45 |
Mail Order $35 |
|
Retirees Over 65 or Under 65 and on Medicare |
Copays Preferred Brand Drugs (B) |
Standard Network Retail* |
Preferred Network Retail** |
Mail Order |
|
Retirees Over 65 or Under 65 and on Medicare |
Copays 30-Day Supply |
Standard Network Retail* $40 |
Preferred Network Retail** $40 |
Mail Order $90 |
|
Retirees Over 65 or Under 65 and on Medicare |
Copays 60-Day Supply |
Standard Network Retail* $80 |
Preferred Network Retail** $80 |
Mail Order $90 |
|
Retirees Over 65 or Under 65 and on Medicare |
Copays 90-Day Supply |
Standard Network Retail* $90 |
Preferred Network Retail** $120 |
Mail Order $90 |
|
Retirees Over 65 or Under 65 and on Medicare |
Copays Non-Preferred Brand Drugs (C) |
Standard Network Retail* |
Preferred Network Retail** |
Mail Order |
|
Retirees Over 65 or Under 65 and on Medicare |
Copays 30-Day Supply |
Standard Network Retail* $60 |
Preferred Network Retail** $60 |
Mail Order $135 |
|
Retirees Over 65 or Under 65 and on Medicare |
Copays 60-Day Supply |
Standard Network Retail* $120 |
Preferred Network Retail** $120 |
Mail Order $135 |
|
Retirees Over 65 or Under 65 and on Medicare |
Copays 90-Day Supply |
Standard Network Retail* $135 |
Preferred Network Retail** $180 |
Mail Order $135 |
* The plan has a network of pharmacies, including retail, mail-order, long-term care and home infusion pharmacies. To find a network pharmacy near you, call the Pharmacy Benefit Manager at the number listed on your card.
** The network includes preferred network retail pharmacies, which may offer you lower costs than other network pharmacies. If you use a preferred network pharmacy, the deductible will be waived if your script is for a 90-Day supply.
- The active ingredients in generic drugs are exactly the same as the active ingredients in brand drugs whose patents have expired. They are required by the FDA to be as safe and effective as the brand drug.
- Brand drugs that do not have a generic equivalent and are included on a preferred drug list.
- Brand drugs that are not on a preferred drug list and usually are a higher cost. For information about your copays when you fill prescriptions for specialty drugs, please see the 2023 Summary of Benefits.
Although Con Edison currently sponsors the Retiree Health Program, the information above does not alter the company’s right to change or terminate the program at any time due to changes in laws governing employee benefit plans, the requirements of the Internal Revenue Code, Employee Retirement Income Security Act, or for any other reason. The company is not obligated to contribute any fixed amount or percentage of program costs.
Notice of Privacy Practices
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is a federal law that requires Con Edison and the health plans sponsored by the company to protect your personal health information (PHI). As a participant under one of the health plans offered by Con Edison, we are required to notify you of the privacy practices that will be followed by the company and the plans and your rights concerning your personal health information.
Under the law and privacy practices, we have the responsibility to protect the privacy of your personal health information by:
6. limiting who may see it:
7. limiting how we may use or disclose it
8. explaining our legal duties and privacy practices
9. adhering to these privacy practices
10. informing you of your legal rights