The prescription drug card program covers prescription drugs that you obtain on an
outpatient basis.
To receive prescription drug benefits under the Plan, you must visit a participating
pharmacy and present your ID card or use the provider's mail order program. If you fill
your prescription at a non-participating pharmacy, it will not be covered by the Plan.
Before prescription drug benefits are payable, you must meet the prescription drug
deductible that is listed in your Schedule of Benefits. You will also be responsible to make
a copayment for your prescription drug benefits. Copayments are listed in your Schedule
of Benefits and differ, depending on whether you are receiving a generic, preferred
brand-name, or non-preferred brand-name drugs.
For more information regarding vision benefits please see page 49-51 in your Summary
Plan Description.