Provider Directory News Room About Us Contact Us Site Map Careers Community Involvement
Home
THURSDAY, AUGUST 28, 2008
Home
Member Sign On
Plan Information
NJ DIRECT 10/15
Prescription Drug Plans
Dental
Self Service
Staying Healthy
Getting Care
Help
 
 
Plan Information
Employee Prescription Drug Plan

The Employee Prescription Drug Plan is offered to active State employees and their eligible dependents as a separate prescription drug plan. Local employers may also elect* to provide the SHBP Employee Prescription Drug Plan to their employees as a separate prescription drug benefit.

Employee Prescription Drug Plan benefits are available through a participating retail pharmacy or through the Caremark mail order service.

  • Retail pharmacy services require a copayment for each 30-day supply. You may obtain a 90-day supply of prescription drugs at a participating retail pharmacy.
  • Mail order participants can receive up to a 90-day supply of prescription drugs for one copayment through Caremark.
*Employees whose local employer does not offer a separate prescription drug plan have prescription drug coverage through the Employee Prescription Drug Reimbursement Plan. See NJ DIRECT section for more information.

Retiree Prescription Drug Coverage

Retirees enrolled in NJ DIRECT have access to a separate prescription drug plan that includes retail pharmacies and a mail order service through Caremark. The plan features a three-tier copayment design - Tier I for generic drugs, Tier II for preferred brand name drugs, and Tier III for all other brand name drugs. You may purchase up to a 90-day supply of medication at a retail pharmacy when prescribed, by paying the applicable copayment for each 30-day supply. Mail order service provides up to a 90-day supply for a single copayment. An annual, per person, prescription drug copayment maximum applies which limits your out-of-pocket expenses.

Important Note regarding Medicare Part D
Most Medicare eligible retirees and/or their Medicare eligible dependents should not enroll in Medicare Part D. Some members who qualify for low income subsidy programs may find it beneficial to enroll in Medicare Part D. However, once you and/or your dependents enroll in Medicare Part D, your SHBP Retiree Prescription Drug Coverage benefits will be terminated for you and your dependents.

Caremark Specialty Pharmacy Program

SHBP Prescription Drug Plans will include an exclusive arrangement with Caremark Specialty Pharmacy for the purchase of specialty pharmaceuticals. Specialty pharmaceuticals are a class of medications that are typically produced through biotechnology, administered by injection and/or require special patient monitoring and handling. To be eligible, specialty pharmaceuticals must be purchased from the Caremark Specialty Pharmacy. For more information, click here.

Click here to be redirected to the NJ Division of Pensions and Benefits Web site which includes a detailed description of Prescription Drug Benefits for retirees in the NJ State Health Benefits Program NJ DIRECT Member Handbook.


This section includes only a general description of the benefits available to members of the NJ State Health Benefits Program. The benefits described are subject to all of the terms, conditions, limitations and definitions included in the Plan documents. If there is a contradiction between the benefits described in this section and those provided in the Plan documents, the Plan documents will prevail.


NJ Division of Pensions and Benefits - State Health Benefits Program
Here you will find information such as the Summary Plan Description, Member Handbooks, Plan Comparisons, Enrollment Forms, and more.

 
Member Sign In
My Health Manager is available to registered members only.

Sign In

NOT A MEMBER?
Click here to register.