The retail co-pay for generic drugs at network pharmacies is being reduced to zero. Participants making retail purchases from a pharmacy may receive a 30-day supply. There is no deductible for mail order prescriptions. Most hospital bills are processed as hospital charges according to the rules of the Hospital Program benefit. But some hospital bills are processed according to the rules of the Major Medical Program and are subject to a deductible and less favorable co-payment rules.
Care rendered in a hospital is far more expensive.
For example, statistics show that an emergency room visit costs from four to ten times more than a comparable visit to a doctor. The plan is designed, therefore, to facilitate hospital use when appropriate, but to discourage its use when reasonable alternatives are available. Benefits under the Plan are provided in whole from the trust funds. A total of 20,758 participants were eligible to receive either current or future benefits from the Plan at the end of the year. Benefits under the Plan are provided in whole from the trust funds.