| Use mail-order pharmacy
Chiropractic care
24-hour nurse line
Dependent audit phase 1
Dependent audit amnesty period is over
Know your prescription benefit
– use mail order
If you are taking long-term maintenance medications, it’s cheaper to use a mail-order pharmacy for your prescriptions. You can receive a three-month supply of your medicines for a two-month copayment. See the chart below to compare costs.
Mail-order prescription benefits |
|
HMO, PPO
and Out-of-Area |
TexanPlus |
Texas HealthSpring |
| Mail-order Company |
|
|
|
| Annual Limit |
No limit |
$4,000 limit for brand and nonpreferred brand; no limit on generics |
$4,000 limit for brand and nonpreferred brand; no limit on generics |
Mail order
90-day supply |
$20 generic/ $60 brand name/ $90 nonpreferred |
Network Pharmacy
30-day supply |
$10 generic/ $30 brand name/ $45 nonpreferred |
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Chiropractic care
The HMO, PPO and Out-of-Area plans cover chiropractors treating “body distortions.” Body distortion means structural imbalance, distortion, or incomplete or partial dislocation in the human body, interfering with nerves or the vertebral column.
The PPO and Out-of-Area plans have a combined annual benefit of $1,000 after the deductible. The HMO does not have an annual limit.
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24-hour nurse line
A 24-hour nurse line has registered nurses who provide information and suggestions for nonemergency medical situations. The registered nurses help you decide when self-care is appropriate, when to call a doctor and when to apply emergency first aid or seek emergency care. For emergencies, call 911 immediately.
• HMO, PPO, Out-of-Area members
Call Carewise
(800) 987-7597
• TexanPlus members
Call MyNurse
(800) 999-9005
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Dependent audit phase 1
Results of Phase I: More than 800 active/retired employees submitted forms to drop dependents from their medical plan. In most cases, dependents were over the age limit, covered under their employer’s plans, grandchildren who no longer live with employees, or ex-spouses were still listed.
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Dependent audit amnesty period is over
The amnesty period ended April 30 and the second phase of the dependent audit is underway. The Human Resources benefits division will randomly select files of active and retired employees. The division will verify that covered persons are eligible and that files contain documentation to support their relationship to the active/retired person. Eligible dependents under the city’s benefits plans are a legal spouse, natural-born children, legal stepchildren, adopted children, legal foster children and grandchildren.
If your benefits file is selected for auditing and it does not include documentation showing the covered person’s relationship to you, you will be required to provide it. Documents include marriage license, declaration and certification of an informal marriage certificate for a common-law marriage, birth certificate(s) and legal documents for covered persons who are not your natural children. If you cover someone who does not qualify as an eligible dependent, you may be penalized.
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