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Health Plans | Prescription Benefit | Request for Proposal

StayWell has secured the services of LDI to manage the pharmacy Benefit. StayWell pays the Eligible Charges for prescription drugs listed on the approved Formulary. StayWell will pay 50% of Eligible Charges for Medically Necessary drugs not listed on the Formulary. For more information, visit LDI's website at www.LDIRx.com.

StayWell members who are taking maintenance medication for a chronic condition (such as diabetes, arthritis, hypertension or heart problems) are encouraged to use the Medicine by Mail program. The Co-payment will be waived for drugs listed on the Formulary.

A listing of participating pharmacies is available to members who need prescription refills while traveling to the U.S. mainland and Hawaii. Visit the StayWell office to obtain the list.

 

A formulary is a list of the medications that StayWell agrees to cover. This list is updated on a regular basis and StayWell members may search their prescription drug at www.LDIrx.com to determine if the medication is a formulary medication. Typically, the plan pays part of the cost for prescriptions, and the member pay the rest. The amount for which the member is responsible is called the copayment.

The formulary is divided into two categories based on how much the member is expected to pay. The copayment is generally higher for brand-name drugs. When several brand-name drugs are available to treat the same condition, the health plan designates one as the preferred choice or formulary. In general, the copayment is lower for generic drugs. Generics are made from the same active ingredients as brand-name drugs and are just as safe and effective, but they are usually less expensive. If the option is available, getting a prescription filled with a generic will result in money saved.

 

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