Tri-County Schools Insurance Group offers several methods
for you to obtain your prescriptions.
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Retail Pharmacy - 31-Day Supply
Present your medical I.D. card with your prescription. The pharmacist will fill your prescription and submit your claim electronically for you. You will be charged a copay based on the following criteria:
Generic - $5
Preferred Brand - 25% to a maximum of $35
Non-Preferred Brand - 45% to a maximum of $70
A covered person may elect a brand name product when a generic is available; however, the covered person will be liable for the difference in cost between the brand name and the generic drug along with the brand name copay.
A generic or formulary drug will automatically be substituted for a brand name drug unless there are health reasons and a letter of medical necessity from the prescribing physician has been received and approved by a panel of clinical pharmacists at EnvisionRxOptions. For your convenience letters of medical necessity can be faxed by the physician's office directly to Envision's clinical staff at (330) 405-8081. Letter of Medical Necessity Form
To locate a participating pharmacy or research prescription drug information, you can log onto EnvisionRx's website at www.envisionrx.com.
| Retail Pharmacy - 90-Day Supply | back to top |
Currently available at the following pharmacies: Bel Air, CVS, Kmart, Longs, Marysville Medicine Shoppe, Peach Tree Pharmacy, PJ's, Raley's, Rite Aid, Safeway, Target, Walgreens or Walmart.
Generic - $10
Preferred Brand - $50
Non-Preferred Brand - $90
When the retail cost of a Preferred or Non-Preferred Brand name drug is more than $67.00, you can save money using the Retail 90-day supply program.
This program was designed for individuals using maintenance medications for long-term medical conditions.
Have your doctor write your prescription for a 90-day supply with three refills, if appropriate.A covered person may elect a brand name product when a generic is available; however, the covered person will be liable for the difference in cost between the brand name and the generic drug along with the brand name copay.
A generic or formulary drug will automatically be substituted for a brand name drug unless there are health reasons and a letter of medical necessity from the prescribing physician has been received and approved by a panel of clinical pharmacists at EnvisionRxOptions. For your convenience letters of medical necessity can be faxed by the physician's office directly to Envision's clinical staff at (330) 405-8081.
To locate a participating pharmacy or research prescription drug information, you can log onto EnvisionRx's website at www.envisionrx.com.
| Mail Order Pharmacy - 90-Day Supply | back to top |
Generic - $10
Preferred Brand - $50
Non-Preferred Brand - $90
When the retail cost of a Preferred or Non-Preferred Brand name drug is more than $67.00, you can save money using the mail order pharmacy.
This program was designed for individuals using maintenance medications for long-term medical conditions.
• Have your doctor write your prescription for a 90-day supply with three refills, if appropriate.
• Complete the Order Form and Patient Profile questionnaire. The questionnaire will only need to be completed with your first order.
• Select method of payment, i.e., credit card or check. Online ordering is available after your initial order.
A covered person may elect a brand name product when a generic is available; however, the covered person will be liable for the difference in cost between the brand name and the generic drug along with the brand name copay.
A generic or formulary drug will automatically be substituted for a brand name drug unless there are health reasons and a letter of medical necessity from the prescribing physician has been received and approved by a panel of clinical pharmacists at EnvisionRxOptions. For your convenience letters of medical necessity can be faxed by the physician's office directly to Envision's clinical staff (330) 405-8081.
Letter of Medical Necessity Form
Orchard Pharmaceuticals
P. O. Box 3094
North Canton, OH 44720
Customer service representatives are available at (866) 909-5170, Monday through Friday, 8:00 a.m. - 8:00 p.m. EST. (866) 909-5169 TTY
For Refills:
To order by phone, call (866) 909-5170
To order online, visit at www.orchardrx.com.
Helpful hints to using the mail order pharmacy program:
Always place your order at least 14 days before you will need your medication.
Always ask your physician to write the prescription for a 90-day supply.
Ask your physician to allow generic substitution.
Always obtain a new written prescription when requested by Orchard Pharmaceutial.
Always send your payment with your order.
Letter of Medical Necessity Form
