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As the flu season is not far away, OP&F has requested that Medco Health Solutions, Inc., OP&F�s pharmacy benefit manager, make several changes to its prescription drug benefit plan.
Antiviral medications that are used to prevent and treat influenza were previously excluded, however they are now covered under Medco�s prescription drug benefit plan. Antiviral medications include but are not limited to Relenza, Tamiflu, and Flumadine.
For those enrolled in Option 1 of the OP&F�sponsored prescription drug plan, Relenza and Tamiflu are currently considered to be preferred brand drugs under the Prescription Selections Formulary. Flumadine is currently considered by Medco to be a non�preferred brand drug. By selecting a preferred brand flu medication, you will have a lower co�pay amount than if you choose the non�preferred brand.
It is recommended that getting a flu shot is one of the best ways to fight the flu and stay healthy.
Until October 24, only those categorized by the Center for Disease Control (CDC) as high risk will be offered flu shots. High�risk individuals include persons age 65 or older, as well as those with certain chronic illnesses. Your doctor can best advise you regarding your health risk status.
Beginning October 24, all those enrolled in the OP&F�sponsored health care plan will be offered flu shots. Maxim Health Systems is offering flu shot services to Aetna PPO and HMO members. The arrangement allows Aetna members to obtain a flu shot from any Maxim flu clinic location and at the same benefit level as if received from their physician. Also, Maxim does not charge an office visit co�pay.
For Aetna members to locate the closest Maxim flu clinic:
As with visits to any health care professional, members should present their Aetna ID card when visiting a Maxim flu clinic. Maxim will not collect fees at the flu shot clinic from Aetna members presenting their Aetna ID cards.
For those enrolled with a provider other than Aetna, flu shots are covered at 100 percent from an in�network physician after the required office visit co�pay. Out of network services are covered at 70 percent.
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