Clinical Services & Vision Program

Eligibility

As a TeamstersCare member, you and your spouse are eligible to participate in the Retiree Prescription Drug Program if:

  • You are at least 65 years old
  • You have met all eligibility requirements for the Early Retiree Medical Program

Enrollment

You can join the Retiree Prescription Drug Program on the first day of the month you turn 65 or when your active coverage ends, provided you meet all eligibility requirements. To enroll, you must notify TeamstersCare Member Services in writing within 30 days of becoming eligible. Failure to do so will result in ineligibility for later enrollment.

Deferred Enrollment

If you have other group health coverage, such as an employer-sponsored plan or COBRA, you may defer enrollment in the Prescription Drug Program by:

  1. Providing written notice to TeamstersCare explaining that your other coverage is the reason for declining enrollment.

You can request special enrollment within 30 days of losing your other coverage by submitting proof that it has ended. Coverage will begin no later than the first day of the month after your application is received.

Enrolling Dependents

Your spouse’s coverage under the Retiree Prescription Drug Program begins the first day of the month they turn 65. If you marry while enrolled, you may enroll your spouse (age 65 or older) by submitting a request within 30 days of your marriage, along with a copy of your marriage certificate.

Pharmacy

As a member of the Retiree Prescription Drug Program, you can access your pharmacy benefits in one of the following ways:

Option #1: TeamstersCare Walk-in Service

You and your spouse can obtain up to a 90-day supply of prescription drugs at either the Charlestown or Stoughton TeamstersCare in-house pharmacies. The cost is $5 for generic and $15 for brand name medications.

 

To fill a new prescription:
You may visit the pharmacy during business hours or have your doctor phone, fax, or e-prescribe your medication.

To refill a prescription, you have two options:

  • Phone: Call the Charlestown or Stoughton pharmacy and use the automated Telemanager to request a refill.
  • Online: Download the PocketRx app on iTunes or Google Play to refill your prescription on the go.

Note: Make sure you have your prescription available, as you’ll need the six-digit refill number.

Option #2: Mail-Order Service

You can receive up to a 90-day supply of your prescription drug through Express Scripts mail order service. The cost is $5 for generic and $15 for brand name medications (if no generic is available).

To fill a mail-order prescription:
Mail your prescription and copay, along with the Prescription Order Form, to Express Scripts. The form is available by calling Express Scripts at (877) 543-7097 or by visiting www.Express-Scripts.com.

To refill a mail-order prescription, you can:

  • Log in to www.Express-Scripts.com and click “Order Status.”
  • Call the Express Scripts automated phone service at 1-877-543-7097.
  • Mail a Refill Request Form with your refill slip or prescription label to Express Scripts.

Specialty Medications

For specialty medications (certain high-cost drugs used to treat complex conditions), prescriptions must be filled through either TeamstersCare in-house pharmacies (walk-in service) or Accredo, the Express Scripts Specialty Pharmacy (mail order only). The copayment is $15 for up to a 30-day supply.

Dental

As a member of our Retiree Prescription Drug Program, you and your spouse have access to a broad range of dental services through the TeamstersCare dental offices in Charlestown, Chelmsford and Stoughton.

These services include:

  • Preventative care including dental exams, x-rays, fluoride treatment, cleaning and scaling
  • Sealants
  • Fillings, root canals for certain teeth and simple extractions
  • Full or partial dentures, including denture repair and reline
  • Mouth guards
  • Second opinions
  • Emergency care (during office hours)

There is no cost for preventative care visits. There is a $5 fee for filling visits and a $10 fee for denture, root canal and extraction visits.

The Retiree Prescription Drug Program does not cover dental services or supplies received anywhere other than at an in-house TeamstersCare office.

Vision

TeamstersCare has contracted with Davis Vision to provide you and your family with benefits to protect your vision and eye health. With a national network of participating providers, you may visit any Davis Vision eye specialist for a broad range of eye care services and supplies – often at no cost to you.

For a list of participating providers, call Davis Vision at 1-800-999-5431 or visit www.davisvision.com. You may also contact TeamstersCare Member Services for a list of New England providers.

To view vision benefits please click here.

Important Note: When choosing either eyeglasses or contact lenses, you must make your full selection at the time of your examination. If you go to a provider who only provides an exam, you must order glasses through another provider within 30 days of your vision exam.

Hearing

Hearing Test Eligibility

Once a year, you and your spouse are eligible for a comprehensive hearing test at the Charlestown Audiology Office.

All routine hearing examinations, diagnostic evaluations, and middle ear analyses are provided at no cost. Services include:

  • Ear examinations
  • Diagnostic hearing evaluations
  • Middle ear analysis
  • Referral to an approved TeamstersCare vendor for hearing aid purchases, if necessary.

Hearing Aid Discount

Under the Retiree Prescription Drug Program, hearing aids are not a covered benefit. However, you and your spouse (age 65 and older) are eligible for significant discounts on medically necessary hearing aids.

To obtain the discount:

  1. Schedule a hearing evaluation at the Charlestown Appointment Desk.
  2. If hearing aids are recommended, you’ll receive a copy of your hearing test and a list of preferred vendors.
  3. You will also receive a voucher for a 15-20% discount on your hearing aid purchase.

To schedule a hearing exam, contact the Charlestown Appointment Desk.

Hearing Aid Service & Repair

If you purchased your hearing aid from an outside vendor, please return it to that vendor for any service or repairs. The cost of repairs is not a covered benefit.

If you obtained your hearing aid through the Charlestown Audiology Office while eligible for the TeamstersCare hearing aid benefit, we will cover necessary repairs for up to eight years after purchase—provided you are enrolled in a TeamstersCare program at the time of the repair.

Clinical Services & Vision Program

Eligibility

As a TeamstersCare member, you and your spouse are eligible to participate in the Retiree Clinical Services and Vision Program if:

  • You are at least 65 years old  AND
  • You have met all of the eligibility requirements for the Early Retiree Medical Program.

Enrollment

You are eligible to join the Retiree Clinical Services Program starting the first day of the month of your 65th birthday or the last day of your active coverage, as long as you are age 65 or older and meet all eligibility requirements.

To enroll (either immediately or on a deferred basis), you must provide written notification to TeamstersCare Member Services within 30 days of becoming eligible. If you do not notify Member Services, you will not be able to enroll at a later date.

Deferred Enrollment

In most cases, you’ll likely join the Clinical Services Program as soon as you become eligible. However, if you are covered by another group health plan when you become eligible, you can defer enrollment if:

  • You have other group health coverage, such as an employer-sponsored plan or COBRA, at the time TeamstersCare offers you retiree coverage, and
  • You provide written notification to TeamstersCare explaining that your other coverage is the reason for deferring enrollment.

Special Enrollment

You may request special enrollment into the Retiree Clinical Services Program if:

  • You become ineligible for your other health coverage, or
  • Your COBRA coverage ends.

To request special enrollment, submit your request within 30 days of losing your other coverage, along with proof that your coverage has ended. Provided you are otherwise eligible, your TeamstersCare coverage will begin no later than the first day of the month following receipt of your application.

Enrolling Dependents

Spousal coverage under the TeamstersCare Retiree Clinical Services Program begins the first day of the month your spouse turns 65. If you marry while enrolled in the program, you may enroll your spouse (age 65 or older) by requesting enrollment within 30 days of your marriage and providing a copy of your marriage certificate.

Dental

As a member of our Retiree Clinical Services and Vision Program, you and your spouse have access to a broad range of dental services through the TeamstersCare dental offices in Charlestown, Chelmsford and Stoughton.

These services include:

  • Preventative care including dental exams, x-rays, fluoride treatment, cleaning and scaling
  • Sealants
  • Fillings, root canals for certain teeth and simple extractions
  • Full or partial dentures, including denture repair and reline
  • Mouth guards
  • Second opinions
  • Emergency care (during office hours)

There is no cost for preventative care visits. There is a $5 fee for filling visits and a $10 fee for denture, root canal and extraction visits.

The Retiree Program does not cover dental services or supplies received anywhere other than at an in-house TeamstersCare office.

Vision

TeamstersCare has contracted with Davis Vision to provide you and your family with benefits to protect your vision and eye health. With a national network of participating providers, you may visit any Davis Vision eye specialist for a broad range of eye care services and supplies – often at no cost to you.

For a list of participating providers, call Davis Vision at 1-800-999-5431 or visit www.davisvision.com. You may also contact TeamstersCare Member Services for a list of New England providers.

To view vision benefits please click here.

Important Note: When choosing either eyeglasses or contact lenses, you must make your full selection at the time of your examination. If you go to a provider who only provides an exam, you must order glasses through another provider within 30 days of your vision exam.

Hearing

Annual Hearing Test Eligibility

Once a year, you and your spouse are eligible for a comprehensive hearing test at the Charlestown Audiology Office.

All routine hearing exams, diagnostic evaluations, and middle ear analyses are provided at no cost. Services include:

  • Ear examinations
  • Diagnostic hearing evaluations
  • Middle ear analysis
  • Referral to an approved TeamstersCare vendor for hearing aid purchases, if necessary.

Hearing Aid Discount

Under the Retiree Program, hearing aids are not a covered benefit. However, you and your spouse (age 65 and older) are eligible for significant discounts on medically necessary hearing aids.

To obtain the discount:

  1. Schedule a hearing evaluation at the Charlestown Appointment Desk.
  2. If hearing aids are recommended, you’ll receive a copy of your hearing test and a list of preferred providers.
  3. You will also receive a voucher for a 15-20% discount on your hearing aid purchase.

To schedule a hearing exam, contact the Charlestown Appointment Desk.

Hearing Aid Service & Repair

If you purchased your hearing aid from an outside vendor, please return it to that vendor for any service or repairs. The cost of repairs is not a covered benefit.

If you obtained your hearing aid through the TeamstersCare Audiology Office while eligible for the TeamstersCare hearing aid benefit, necessary repairs will be covered for up to eight years after purchase—provided you are enrolled in a TeamstersCare program at the time of the repair.

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