Medco Health Solutions, Inc. to Administer SHBP/SEHBP Pharmacy Benefits

Effective January 1, 2010*, the State Health Benefits Program/School Employees’ Health Benefits Program (SHBP/SEHBP) prescription drug benefit will be managed by Medco Health Solutions, Inc. (Medco). 
In December 2009, Medco distributed Welcome Packages to covered members that explained the benefit, provided instructions on the prescription services and included the Medco prescription drug ID card(s).  Beginning January 1, 2010*, members should present the Medco prescription drug ID card to the pharmacist when filling prescriptions.

In most cases, members with refills remaining with CVS Caremark mail order prescription(s) do not need to get a new prescription.  Before filling the next order, Medco will need to confirm that the prescription information has been transferred correctly from CVS Caremark.  A refill request should be submitted when a two-week supply of medication remains.  After January 1, 2010*, members can refill prescriptions through Medco.  Please note, however, that controlled substances and compound medications were not transferred.  A new prescription from the prescribing physician is required for these medications.  Instructions for submitting new prescriptions to the Medco pharmacy were included with the Welcome Package.

Questions regarding the SHBP/SEHBP prescription drug benefit administered by Medco should be directed to Medco at 1-866-220-6512 or visit www.medco.com/statenewjersey.

*January 2, 2010, for those members paid through the State’s Centralized Payroll Unit.

Click the above link for more information, including a detailed description of the prescription drug plans for the SHBP/SEHBP, the summary plan description, member handbooks, plan comparisons, enrollment forms and more.

Members of local employer groups should check with their benefits administrator for plan information, as employers may offer a prescription plan other than the SHBP/SEHBP plan.  General information regarding group coverage with Horizon BCBSNJ is available for review at www.HorizonBlue.com.

This section includes only a general description of the benefits available to members of the NJ State Health Benefits Program and School Employees' 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.