Coverage
Your NY44 Medical Plan coverage includes coverage for prescription drugs. The Pharmacy Plan is administered by NOVA/Independent Health.
| Traditional Plan | Core Plan | Progressive Plan* | |
| Tier One | $0 | $5 | $5 |
| Tier Two | $15 | $25 | $40 |
| Tier Three | $30 | $60 | $75 |
*The Progressive Plan Rx Copays are first to subject to this plan’s deductible.
Mail Order Prescriptions
In order to be covered under The Pharmacy Plan, maintenance medications normally prescribed for long-term, chronic conditions must only be obtained via mail order. You may receive up to a 90-day supply of your maintenance medications by paying only 2.5 monthly copayments.
Using Mail Order
- Obtain a new prescription from your provider written for a 90-day supply plus refills for up to one year (as appropriate).
- Register by phone with either Wegman’s or ProAct. You will need your ID card when registering with the mail-order pharmacy. You may also register online, and you should confirm your registration afterward by calling.
- Pay your copayment using Visa, MasterCard, Discover, American Express or by check or money order.
- Your medications will be shipped to you. It may take two weeks for you to receive your initial order in the mail, so make sure you have at least a 14-day supply before ordering or ask your provider for a 30-day supply to fill at your local pharmacy.
Click Here for a Mail Order Tip Sheet.
In The News: 2020 Formulary Updates
On February 13, 2020, the U.S. Food & Drug Administration (FDA) requested the manufacturer of Belviq® and Belviq XR® (lorcaserin) to voluntarily withdraw the drug. The FDA encourages patients to stop taking Belviq® / Belviq XR® and talk to their doctor about alternative weight-loss medicines and weight management systems.
Effective 2/14/20, this medication is no longer a covered benefit for PBD prescription drug plans. It was removed from coverage due to safety concerns. If you’d like additional information regarding this change, please click here.
Resources
Click here or visit www.pbdrx.com for more details about the prescription drugs covered by your insurance.
PBD Member Services Department:
Phone: 716-635-7880 or 1-888-878-9172
Email: servicing@pbdrx.com
Hours of Operation: M-F; 8am-11pm EST
Please call this number with any issues or concerns relating to your prescription benefit. Please note: Due to HIPAA requirements, our representatives can only speak to the member (or parent/guardian) for which the prescription applies, unless verbal or written authorization by the member is provided.
ProAct
Find more information at https://www.proactpharmacyservicespbd.com/ or call 888-425-3301 (TTY:National 711 Relay Service).
Click here for the ProAct Patient Profile form.
Click here for the ProAct Automatic Refill form.
Wegman’s
Find more information at http://www.Wegmans.com/Pharmacy or call 888-205-8573 (888-205-8573 TTY/DD).
Click Here for Wegman’s Mail Order Form.