YourPrescriptionDrugBenefitPlan

ZZ24 11/29/01 12:03 PM Page 1

Welcome!Oxford Health Plans has chosen Merck-Medco to manageyour prescription drug benefits. Merck-Medco is one of thenation’s leading pharmacy benefit managers, helping to servethe prescription needs of over 65 million Americans. Wehave developed this brochure to make your prescriptiondrug benefits easy to use and understand.

Whether you get your medications through the Merck-Medconetwork of participating retail pharmacies or through theMerck-Medco Home Delivery Pharmacy Service™ (mailorder service), you can confidently rely upon Merck-Medco’s clinical expertise and state-of-the-art technology.

Table of contentsYour prescription drug benefits .......................................................................... 1The Home Delivery Pharmacy Service™(mail order service)........................ 2-5Your retail network pharmacy service ................................................................ 6The Merck-Medco website .................................................................................. 7Your privacy and safety ........................................................................................ 8The generic drug advantage ................................................................................ 9Information anytime by telephone .................................................................... 10Answers to your questions............................................................................ 11-12How to reach us .................................................................................. Back cover

ZZ24 11/29/01 12:03 PM Page 2

1

Your prescription drug benefits*

Merck-Medco. has a comprehensive retail pharmacy network of nearly 50,000locations nationwide, including approximately 6,000 in the tri-state area. Majorchains include CVS, Eckerd, Genovese, Medicine Shoppe, Stop & Shop andWal-Mart.

*Please refer to your Summary of Benefits and Certificate of Coverage fordetailed information regarding your pharmacy coverage.

Your Prescription Drug FormularyYour prescription drug benefit plan includes a Prescription Drug Formulary,which contains a list of drugs that are preferred by your plan. These aredesignated in the Formulary as being on the Preferred Drug List. This listincludes a wide selection of drugs and is preferred because it offers you choiceand helps to keep the cost of your prescription drug benefit affordable. Eachdrug is approved by the Food and Drug Administration (FDA) and reviewed byan independent group of doctors and pharmacists. Your plan may encouragethe use of the preferred drugs on this list to help control rising drug costs. We may remind your doctor when a preferred drug is available as a possiblealternative for a drug that is not on Oxford’s Preferred Drug List. This mayresult in a change in your prescription. However, your doctor will always makethe final decision on your medication.

*This information is an overview of your plan sponsor’s prescription drug benefit program. Please note that benefits and co-paymentsare subject to change by your plan sponsor.

Your prescription drug benefits

ZZ24 11/29/01 12:03 PM Page 3

The Merck-Medco Home Delivery Pharmacy Service™ (mail order service)The Merck-Medco Home Delivery Pharmacy Service™offers you convenienceand potential cost savings.

For your chronic maintenance prescription needs

If you need medication on an ongoing basis, such as you might need to treat asthma or diabetes, you can ask your doctor to prescribe up to a 90-day supply for home delivery, plus refills for up to 1 year. You will pay theapplicable copayment(s) for each prescription or refill, based upon your plandesign. Please refer to your Summary of Benefits and Certificate of Coverage formore information.

Oxford offers members the ability to obtain certain medications withinfourteen therapeutic categories of medications through the Merck-MedcoHome Delivery Pharmacy Service™. Maintenance prescriptions to treat thefollowing medical conditions will be dispensed through Merck-Medco’s HomeDelivery Pharmacy Service™:

• Benign Prostate Hypertrophy• Chronic Cardiovascular Disorders• Chronic Hyperlipidemia• Chronic Obstructive Pulmonary Disease• Clotting Disorders• Colitis• Diabetes• Estrogen Therapy• Glaucoma• Gout• Hypertension• Osteoporosis• Seizure Disorders• Thyroid Disease

With the Home Delivery Pharmacy Service™• Your medications are dispensed by a home delivery pharmacy and

delivered to your home.• Medications are shipped by standard delivery at no additional

cost to you. (Express shipping is available for an added charge.)• You can order and track your prescriptions online at

www.merckmedco.com, or you can call in your order throughour toll-free number.

• Registered pharmacists are available around the clock for consultations.

The

Mer

ck-M

edco

Hom

e D

eliv

ery

Phar

mac

y Se

rvic

e

2

ZZ24 11/29/01 12:03 PM Page 4

Using the Home Delivery Pharmacy Service™ for the first timeRequesting a new prescription for Home Delivery is simple whether you’reordering by mail or online. Just follow these steps:

By Mail:

Step 1: Ask your doctor to write a new prescription for up to a 90-day supply, plus refills (if appropriate) for up to one year.

Step 2: Mail the new prescription(s), along with the enclosed “Ordering Medications” form and the appropriate copayment, to Merck-Medco in the return envelope. For more information, see “Paying for your medication” at the end of this section.

On Line:

You can request new prescriptions online by visiting us atwww.merckmedco.com.

Step 1: If you haven’t already done so, take a few moments to register with us, making sure you let us know that you are a Merck-Medco plan member when prompted. Once you are registered, all you need to do when you return is log in using the e-mail address and password you created.

Step 2: Once you are registered and logged in, select the "My Benefits" tab at the top of the page. Then choose the "Order new prescriptions" link and follow the online instructions.

Your medication will be delivered to your home within 7 to 11 business daysafter Merck-Medco’s receipt of your prescription order. Orders placed via theInternet or telephone may be received even faster. Standard shipping is free.

The Merck-M

edco Home D

elivery Pharmacy Service

3

Since your medication can take 7 to 11 business days to be delivered,you should have at least a 3-week supply of that medication on handto hold you over.

You can request additional Home Delivery Pharmacy Service™ orderforms and envelopes through our website, www.merckmedco.com, orby calling 1 800 905-0201 24 hours a day, 7 days a week exceptThanksgiving and Christmas.

ZZ24 11/29/01 12:03 PM Page 5

4

Refilling your prescription

When it’s time to refill your prescription, you have three options.Choose the one that’s easiest for you:

Online:

• Log on to our website at www.merckmedco.com. If you are a first-time visitor, you will need to register online and create a password. The next time you visit, you will only need to enter your e-mail address and password.

• Have your Oxford Rx Member ID number (which is on your Oxford Member ID card) and your prescription number for the medication you would like to refill handy.

• Follow the online instructions to complete your registration.• Each time you log in, available prescription refills will be displayed in your

personalized "My Page," as well as within your "My Prescriptions" center.

By telephone:

• Call 1 800 4REFILL (1 800 473-3455) and use the automated refill system.• Please have your Oxford Rx Member ID number (which is on your

Oxford Member ID card), the prescription number, and your credit card number handy.

By mail:

• Use the refill and order forms that will accompany your initial prescription. Mail them with your copayment to Merck-Medcoin the return envelope.

The

Mer

ck-M

edco

Hom

e D

eliv

ery

Phar

mac

y Se

rvic

eTo make sure that you don’t run out of your medication, rememberto reorder 3 weeks before your medication runs out. You can findthe refill date on the refill slip that comes with every order or onour website at www.merckmedco.com, or call Merck-Medco Member Services at 1 800 905-0201.

ZZ24 11/29/01 12:03 PM Page 6

5

Paying for your medicationYou may pay by Visa®, MasterCard®, Discover®/NOVUS®, American Express®,or Diners Club®, or by check or money order. If you prefer to pay for all ofyour orders by credit card, you may want to join our automatic paymentprogram by calling 1 800 948-8779 or by enrolling online atwww.merckmedco.com.

Please note: By law, Merck-Medco must fill your prescription for the exactquantity of medicine prescribed by your doctor subject to your plan’slimitations. Federal law prohibits the return of dispensed prescriptionmedications.

The Merck-M

edco Home D

elivery Pharmacy Service

ZZ24 11/29/01 12:03 PM Page 7

Your retail network pharmacy service

For your prescription needsFilling prescriptions can be fast and easy when you use one of our retailnetwork pharmacies. These pharmacies will accept your Oxford Rx Member IDcard and charge you the appropriate copayment when you fill a prescriptioncovered by your plan. To find out whether a pharmacy participates in ourprogram: • Ask your retail pharmacist. • Visit our website at www.merckmedco.com and use our

online pharmacy locator. • Call 1 800 905-0201 and use our automated pharmacy locator.

Follow these steps to order new prescriptions or refillsat participating pharmaciesStep 1: Show your Oxford Rx Member ID card at the pharmacy.Step 2: Pay the applicable copayment(s)* {which a representative

at the pharmacy will tell you} when you pick up your prescription.

Note: Copayment requirements vary by plan design. Please refer to yourCertificate of Coverage for more information.

Your

reta

il ne

twor

k ph

arm

acy

serv

ice

6

ZZ24 11/29/01 12:03 PM Page 8

The Merck-Medco website

To learn how to get the most from your prescription drug benefit plan, visit us online at www.merckmedco.com, where you’ll find convenient,timesaving features. For example, through our website, you can:

• Refill, renew, or request new Home Delivery Pharmacy Service™(mail order service) prescriptions.

• Track the status of Home Delivery Pharmacy Service™ orders.• Compare pricing and coverage for brand-name and generic drugs—

for both home delivery and retail.• Keep track of your prescription history and related expenses.• Review your account summary; check and pay balances.• Print Home Delivery Pharmacy Service™ order forms. • Request that Home Delivery Pharmacy Service™ order forms

be mailed to you.• Request claim forms for prescription reimbursement.• Locate and get directions to a participating retail network pharmacy.• Choose to receive e-mail notices so that you can stay informed about your

prescription orders and new website features. • Get the necessary information about your prescription medications and

your plan’s benefits before you visit your doctor.• Take charge of your health with our health and wellness information, tools,

and resources.

7

The Merck-M

edco website

To help get the most from our website, click on the "Register now"link and have your Oxford Rx Member ID number (which is on yourOxford Member ID card) handy. Simply follow the instructions tocomplete the registration. The next time you visit, you will only need to enter your e-mail address and password.

ZZ24 11/29/01 12:03 PM Page 9

8

Your privacy and safety

Your privacy is important to us. Merck-Medco uses the health and prescriptioninformation about you and your dependents to administer your benefitprogram. This process generally involves reporting the information to yourplan administrator/healthcare plan. We also use information and prescriptiondata from claims submitted nationwide for reporting and analysis withoutidentifying individual patients.

When your prescriptions are filled at one of the Merck-Medco home deliverypharmacies, our pharmacists use the health and prescription information wehave on file for you to consider many important clinical factors, including drugselection, dosing, interactions, duration of therapy, and allergies. They alsohave information received from your retail network pharmacy when you haveused your benefit with Merck-Medco. Similar information is provided to yourretail pharmacy at the time a prescription is filled. Merck-Medco may contactyour doctors to discuss certain clinical factors and benefit managementmatters.

Use of medicationsPrescriptions filled through our Home Delivery Pharmacy Service™ will bechecked for potential problems, such as potential interactions with othermedications you may be taking. If a potential problem is identified, anexperienced, registered pharmacist may contact your doctor. If you have anyquestions about your prescriptions, you can call Merck-Medco MemberServices at 1 800 905-0201 and talk to one of our pharmacists 24 hours a day,7 days a week.

We include educational and safety information with every new prescriptionordered through the Home Delivery Pharmacy Service™. By visiting ourwebsite, www.merckmedco.com, you can access this same information as wellas other health-related facts and resources. To take advantage of personalizedhealth alerts, news, and information, be certain to register with us.

Your

priv

acy

and

safe

ty

ZZ24 11/29/01 12:03 PM Page 10

9

The generic drug advantage

Be assured that generic drugs and their brand-name counterparts:

• Have the same active ingredients • Are manufactured according to the same strict federal regulations

Generic drugs may differ in color, size, or shape, but the FDA requires that theyhave the same strength, purity, and quality as the brand-name alternatives.

Prescriptions filled with generic drugs often have lower copayments. Therefore,you may be able to get the same health benefits at a lower cost. You should askyour doctor or pharmacist whether a generic version of your medication isavailable and whether it would be right for you. You can find out moreinformation about generic drugs and their costs based on your prescriptionplan’s guidelines by visiting www.merckmedco.com. Remember to register ifyou are a first time visitor so that you can easily log in when you return youremail address and the password that you create.

The generic drug advantage

ZZ24 11/29/01 12:03 PM Page 11

10

Information anytime by telephone

Our interactive telephone service gives you a convenient way to get informationor materials—at any time of the day or night. And with our voice-activatedfeature, you don’t even have to press numbers on the telephone.

Before you call, you should have your Oxford Rx Member ID number (which is on your Oxford Member ID card) and any other numbers you might need, such as your credit card number or your prescription number. Then dial 1 800 905-0201.

Quick reference For security purposes, you may be asked to enter or speak your 10-digit hometelephone number or your Oxford Rx Member ID number. (This information isconfidential and will not be shared.) You then will have several options:

• To locate a participating retail network pharmacy, say or press 1.• To refill a prescription, say or press 2.• To check the status of an order, say or press 3.• To request a Home Delivery Pharmacy Service™ order form/envelope,

brochure, or retail claim form, say or press 4.

You will hear additional choices. You can respond either by speaking theappropriate number or by pressing numbers on the telephone.

Information anytim

e by telephone

If you are ordering a refill and paying by credit card, please haveyour card information available. Be sure to write down yourconfirmation number after the telephone order is completed in case any questions about your prescription come up later.

ZZ24 11/29/01 12:03 PM Page 12

11

Answ

ers

to y

our

ques

tions

Answers to your questions

Q: How do I know if my medication is covered?

A: To determine if a medication is covered, call Merck-Medco MemberServices at 1 800 905-0201 24 hours a day, 7 days a week (except forThanksgiving and Christmas). To find coverage and pricing details online,visit our website anytime at www.merckmedco.com, register with us, andchoose our "Prescription Coverage & Pricing" feature, located within the"My Prescriptions" area of our site.

Q: How can I start using the Merck-Medco Home DeliveryPharmacy Service™ (mail service)?

A: When your doctor is writing a prescription, let him or her know that yourprescription drug plan permits you to receive up to a 90-day supply ofcertain chronic maintenance medications, plus refills for up to 1 year,through the Home Delivery Pharmacy Service™. Then mail yourprescription(s) along with the enclosed "Ordering Medications" form andrequired copayment in the envelope provided. You can also use our website,www.merckmedco.com, to get started. Simply visit us online, register withus, and visit the "My Benefits" section of the site to learn more about how toget started.

Q: What are chronic maintenance prescription medications?

A: Chronic maintenance prescription medications are drugs used to treat certain chronic medical conditions such as diabetes, high blood pressure, epilepsy, thyroid condition or other conditions that require long-term medication use.

Q: How long will it take to receive my medications?

A: Your medication will be delivered to your home within 7 to 11 business daysof Merck-Medco’s receipt of your prescription order. Since your medication can take 7 to 11 business days to be delivered, you should have at least a 3-week supply of your medication on hand when you place your order.

ZZ24 11/29/01 12:03 PM Page 13

12

Answ

ers

to y

our

ques

tions Q: Are generic drugs as effective as their brand name counterparts?

A: Yes. Generic drugs have the same active ingredients and are manufacturedaccording to the same strict federal regulations. While they may differ incolor, size or shape, the FDA requires that generic drugs have the samestrength, purity and quality as their brand name counterparts.

ZZ24 11/29/01 12:03 PM Page 14

ZZ24 11/29/01 12:03 PM Page 15

www.merckmedco.comMerck-Medco Managed Care, L.L.C.,is a subsidiary of Merck & Co., Inc.Preferred Prescriptions, Rx Selections, and Merck-Medco Home Delivery Pharmacy Service are trademarks of Merck-Medco Managed Care, L.L.C.© 2001 Merck-Medco. All rights reserved.

FORM #ZZ24 (10/01)

*0000000ZZ24!!!!**0000000ZZ24 *

How to reach usYou can reach us at www.merckmedco.com. Visit our website anytime to:• Order and track the status of your home delivery prescriptions.• Check prescription coverage and pricing.• Request Home Delivery Pharmacy Service™ order forms.• Locate a participating retail network pharmacy.• Request claim forms for prescription reimbursement.• Discover a world of health information and much more (see page 7).

How to reach us via phoneYou can reach us at the numbers below. Most services listed are available 24 hours a day, 7 days a week (except for Thanksgiving and Christmas).

To contact Merck-Medco to:• Request Home Delivery Pharmacy Service™ order forms.• Find a participating retail network pharmacy.• Request claim forms for prescription reimbursement.• Speak with a Member Services representative.• Speak with a registered pharmacist at any time. Call 1 800 905-0201.

To refill a Home Delivery Pharmacy Service™ prescription using ourautomated system: Call 1 800 4REFILL (1 800 473-3455).

Home Delivery Pharmacy Service™To arrange credit card payment for all your Home Delivery Pharmacy Service™orders: Call 1 800 948-8779.

To access TTY service for hearing-impaired members: Call 1 800 759-1089.

To request Braille labels for Home Delivery Pharmacy Service™prescriptions:Call 1 800 905-0201.

ZZ24 11/29/01 12:03 PM Page 16