Welcome. Have your doctor s office call , 8 a.m.-8 p.m., CT, Monday-Friday, TTY 711. Or fax

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1 Welcome Prescription Solutions administers your pharmacy benefits on behalf of your plan sponsor. Please take a few moments to review the following information to better understand your pharmacy benefit plan for prescription medications. Us i n g Yo u r ID Ca r d You may present your prescription ID card to any pharmacy who participates in our network. When you fill a prescription, the pharmacy enters your claim into a computer system that automatically files it with us. Your pharmacist then collects the applicable copayment for the prescription purchased. Prescription Solutions Pharmacy Network Our pharmacy network includes more than 64,000 independent and chain retail pharmacies nationwide. To find a participating pharmacy near you, use the Locate a Pharmacy feature on our website www. PrescriptionSolutions.com or call customer service. Using Non -Network Pharmacies If you present your ID card at a non-network pharmacy (or must make a cash purchase for other reasons), you will pay 100 percent of the retail cash price for your prescription. To be reimbursed for eligible prescriptions, you must submit your pharmacy receipt(s) and a claim reimbursement form to us. Reimbursement amounts are based on participating pharmacy contracted rates minus your copayment. See your plan sponsor s benefit manager to obtain a claim reimbursement form or download one from our website. Mail Service Pharmacy Prescription Solutions Mail Service Pharmacy allows you to receive prescription products through the mail with standard delivery right to your home at no additional charge to you. Choose from three easy ways to get started today: Have your doctor s office call , 8 a.m.-8 p.m., CT, Monday-Friday, TTY 711. Or fax Complete a registration/order form and send it to Prescription Solutions along with your written prescription and copayment. Call , 24-hours a day, 7 days a week, TTY 711. Customer Service Prescription Solutions team of dedicated Customer Service Advocates can help you with your pharmacy benefit questions. Contact us 24-hours a day, 7 days a week at For additional information, contact us at hours a day, 7 days a week, or visit our website. This notice does not imply coverage. Plan booklets provide specific benefit and coverage limitations Prescription Solutions. All rights reserved. No part of this document may be reproduced without permission. P.O. Box 8082, Wausau WI Phone: NVPS p 1/1

2 Retail Pharmacies and Retail 90 Rx A well-balanced pharmacy network offers you convenient access and competitive discounts for brand and generic medications. Our national retail pharmacy network includes more than 60,000 chain and independent retail pharmacies, so you re sure to find one close to home or work. Using Your ID Card When you fill a prescription through a participating pharmacy, show the pharmacy your ID card so they can submit a claim for coverage by your pharmacy benefit plan. When you pick up your prescription, the pharmacy then collects your applicable member contribution as defined by your plan. If you do not present your ID card or you fill a prescription at a non-participating pharmacy, you pay the full retail price for your medication. If the prescription is eligible for coverage under your pharmacy benefit plan, you may submit a claim to request reimbursement (forms are available at or by calling customer service ). When you submit a claim using the reimbursement form, Prescription Solutions first determines if your plan covers the medication. If it is covered, the amount you receive is based on contracted pharmacy rates less your plan s out-of-pocket member contribution. All prescription claims are subject to your pharmacy benefit plan s rules and restrictions. Retail 90 Rx Program The Retail 90 Rx Program allows you to receive up to a three-month supply of your medication from more than 59,000 participating retail pharmacies. Like a traditional mail service pharmacy, you can avoid refilling a prescription every month while still getting personalized counsel from a local pharmacy professional. See your benefit plan documents for Retail 90 Rx copayment information. To use Retail 90 Rx, talk with your doctor to see if the program is right for you. If it is, get a prescription written for up to a 90-day supply and take it to a participating Retail 90 Rx pharmacy. Please note, some medications are limited by law and cannot be dispensed as a three-month supply. Not all medications are eligible for this program. Finding a Network Pharmacy You can choose from three easy ways to find participating pharmacies near you: 1. Review the partial list included on the following pages. 2. Go to our website and use the LOCATE A PHARMACY tool. 3. Contact customer service using the number on the back of your benefit plan member ID card.

3 A 90 A&P Pharmacy 90 A S Medication Solutions AADP Accredo Health 90 Acme Pharmacy 90 Ahold USA AHS St. John Pharmacy 90 Albertsons 90 Allina Community Pharmacy 90 American Drug Stores 90 Appalachian Regional Health 90 Apria Healthcare 90 Arrow Prescription Center 90 Aurora Pharmacy B Balls Four B 90 Bartell Drug Bi-Lo 90 Bi-Lo Pharmacy 90 Bimart 90 Bioscrip Pharmacy Brockie Healthcare 90 Brookshire Brothers 90 Brookshire Grocery 90 Buehler Foods Buehlers 90 Care Pharmacies Carle Rx Express Carrs Quality Center Central Dakota Pharmacies 90 City Market (Kroger) 90 Coborn s Pharmacy 90 Concord Food Stores Community Distributors Continuing Care Rx 90 Coram 90 Costco Pharmacies Curascript Infusion Pharmacy Curators of the University of Missouri C 90 CVS/Pharmacy D 90 Dahl s Pharmacy 90 Department of Veterans Affairs Pharmacies 90 Dierbergs Pharmacy 90 Dillon s Pharmacy (Kroger) 90 Discount Drug Mart Doc s Drugs Ltd Dominicks Pharmacy Drug Fair Community Drug World Pharmacies 90 Duane Reade Duluth Clinic Pharmacies E Eaton Apothecary F 90 Fagen Pharmacy 90 Fairview Health Services 90 Familymeds 90 FF Acquisition 90 Food Lion 90 Fred Meyer (Kroger) Fred s Pharmacy Freds Stores of Tennessee Fruth Pharmacy 90 Frys Food And Drug (Kroger) G Gemmel Pharmacy 90 Genuardis Pharmacy 90 Giant Eagle Pharmacy 90 Giant Food Stores 90 Giant Of Maryland 90 Gristedes Pharmacy 90 GRT Atlantic & Pacific Tea H Haggen Food & Pharmacy WA 90 Hannaford Bros 90 Harmons City 90 Harris Teeter Pharmacy Hartig Drug 90 Harvard Vanguard Medical Associates Health Partners 90 HEB Grocery Henry Ford Health System Hi-School Pharmacy 90 HIP Pharmacy Service of NY 90 Homeland Stores Horton and Converse Pharmacy 90 Hy-Vee Food Stores

4 I 90 IHC Health Services Ingles Markets Pharmacy 90 Inserra Supermarkets 90 Insty Meds J 90 JH Harvey Jordan Drug K 90 K Mart Pharmacy 90 Kash in Karry Food Stores 90 Kerr Drug Stores 90 King Kullen Pharmacy 90 King Soopers Pharmacy (Kroger) 90 Kinney Drugs Klingensmith s Drug Stores Knight Drugs Kohll s Pharmacy & Homecare 90 Kroger Pharmacy KS Management Services K-VA-T Food Stores L 90 Levandowski Lifechek 90 LML Enterprises 90 Longs Drug Stores CA 90 Louis and Clark Drug Lovelace Health Systems M M.K. Stores Marc Glassman Market Basket Pharmacies 90 Marsh Drugs Marshfield Clinic Pharmacy 90 Martins Super Markets Maxor Pharmacy 90 Mays Drug Stores Med-Fast Pharmacy 90 Med-X Drug 90 Medfusion Pharmacy 90 Medicap Pharmacies Medicine Centers of Atlanta 90 Medicine Shoppe Mediserv 90 Meijer Mercy Health System Minyard Food Stores Moore and King Pharmacy Morton Drug N 90 Nash Finch Navarro Discount Pharmacy 90 Neighborcare Pharmacy of VA Neighborcare Pharmacy Services New Albertsons Northwest Health Ventures O Omnicare Inc. 90 Oncology Pharmacy Services 90 Option Care P Pacmed Clinics 90 Pamida Stores 90 Park Nicollet Pharmacy Parkway Drugs IL 90 Pathmark Stores Patient First Pavilion Plaza Pharmacy 90 Penn Traffic 90 Perlmart/Shoprite Pharma-Card 90 Pharmacy Express Services 90 Pharmerica 90 Piggly Wiggly 90 Price Chopper Pharmacy Price Cutter Pharmacy 90 Procare Pharmacy Professional Pharmacy Services 90 Publix Super Markets Q 90 QFC (Kroger) Quality Markets Pharmacy 90 Quick Chek Pharmacy Dept 90 Pharmacy participates in Retail 90 Rx. Many independent pharmacies also participate in Retail 90 Rx, and additional chains join monthly. For a complete and up-todate listing, please call customer service.

5 R 90 Raley s Pharmacy 90 Ralphs (Kroger) Randalls 90 Rinderer s Drug Stores 90 Rite Aid Ritzman Pharmacy Ronetco Rxd Pharmacy NJ S Safeway Saint Joseph Mercy Pharmacy 90 Saker Shoprites 90 Sav-Mor Drug Stores 90 Save Mart Supermarkets 90 Schnucks Markets Scott & White Health Plan 90 Shaws Supermarket 90 Shopko Pharmacy 90 Shoprite Supermarkets 90 Smiths Food & Drug Centers (Kroger) 90 Snyder s Drug Store Southern Family Markets S R S 90 St Johns Mercy Pharmacies 90 Stephen L Lafrance Holdings 90 Stop & Shop Pharmacy Super D Drugs 90 Supervalu Pharmacy T Target Pharmacy 90 Thrifty Drug Stores Times Supermarket Tom Thumb Pharmacies 90 TOPS Markets Trihealth Pharmacy U Ukrops Pharmacy United Pharmacy TX University Of Wisconsin 90 University Medical Center 90 University of Utah Pharmacies 90 US Bioservices 90 USA/Super D Drug V Value Drugs NY 90 Village Supermarkets Von s Pharmacy W 90 Walgreens 90 Wal-Mart Pharmacy Weber & Judd 90 Wegmans Food Market 90 Weis Pharmacies 90 Winn-Dixie Stores Z 90 Zallie Supermarkets 90 Pharmacy participates in Retail 90 Rx. Many independent pharmacies also participate in Retail 90 Rx, and additional chains join monthly. For a complete and up-todate listing, please call customer service Main Street, Irvine, CA PrescriptionSolutions.com PS0779A 02/ Prescription Solutions. This document is proprietary to Prescription Solutions and is subject to federal copyright protection. Any unauthorized reproduction, dissemination or use of this document is strictly prohibited.

6 Patient Education: Mail Service Pharmacy Program Prescription Solutions Mail Order Pharmacy makes ordering maintenance medications easy and saves you both time and money compared to a retail pharmacy. Using your mail order where through a retail pharmacy you receive a 30-day supply. Plus, shipping is at no cost to you so you do not have to drive to your local pharmacy. Save Time Save Money Convenient Door-to-Door Service Prescription Solutions uses generic products whenever possible to help reduce your medication costs. Generic medications are FDA approved equivalents to the more expensive brand-name version. If you or your physician prefers the brand-name, please indicate this on your order. Please be aware that the brand-name medication may be subject to a higher copay as determined by your Plan. Contact Customer Service for information about your copays. Pharmacists are Available 24 Hours a Day, 7 Days a Week If you would like a consultation with one of our pharmacists, or you have questions or concerns regarding your medications, pharmacists are available 24 hours a day, 7 days a week. Please call to speak with one of our consultant pharmacists. Your Medication Safety is Protected by Our Professional Staff Every prescription submitted to Prescription Solutions is screened by our team of registered pharmacists for accuracy, drug interactions, allergies and appropriateness of therapy. Prescription Solutions maintains a complete record of all of your we will contact you or your physician. If we are unable to resolve the issue and we anticipate a delay in shipping your order, we will contact you. rofessional Staff y Accuracy ation Screening

7 Four Ways to Get Started Using Mail Service 1 Your physician can Fax us If you would like to save mailing time to Prescription Solutions, your physician can fax your prescriptions directly to our processing center at , 24 hours a day, 7 days a week. (NOTE: Faxed prescriptions can only be 2 Your physician can Phone us Prescription Solutions offers the convenience of Our pharmacist phone team can be reached at , 8 a.m. 8 p.m. Central Time, Monday Friday, excluding certain holidays; TTY/TDD You can Mail in your prescriptions Complete the attached mail-in order form and mail to Prescription Solutions along with your new 90-day prescriptions. Please include your date of birth and ID number on each prescription. For newly prescribed medications, ask your physician to write two prescriptions: one for a Packaging and Delivery To ensure that your order is delivered to you in a timely manner, Prescription Solutions uses USPS along with other national carriers. Standard delivery is at no cost to you, and most orders should arrive in about seven days after usually processed and shipped within 48 hours after the request is received (please allow for postal delivery time). Each shipped order will include a reorder form and detailed drug information for each medication. Refrigerated items are shipped next day delivery in a styrofoam container with ice packs. For certain medications such as controlled substances, signature service may be required. If we need to contact you or your physician about your order, delivery may take longer. If you prefer rush delivery, your order can be shipped your prescription(s) locally if you re out of your medication(s) and can t wait for your mail order prescription to arrive. at your local pharmacy), and one for a 90-day for mail order. For medications you are currently taking, ask your physician to write a prescription 4 We ll Call your physician for you Prescription Solutions will contact your physician to request your prescriptions be converted to a 90-day supply. Provide your medication names and dosages along with your physician s name and phone number. Call hours a day, 7 days a week; TTY/TDD via the automated phone system, or by calling Customer Service. In addition, you will receive a reorder form with each shipment that can be mailed in for processing at your convenience. Once you register online, you will receive an Main Street Irvine, CA PS0384 4/09

8 New Prescription Mail-In Form 1 Please use black or blue ink and mail this completed order form with your new prescription(s). DO NOT STAPLE OR TAPE PRESCRIPTIONS TO THE ORDER FORM. Primary Member ID Number: Plan Name: (Additional coverage, if applicable) Secondary Member ID Number: Plan Name: Last Name First Name MI Delivery Address Apt. # City State ZIP Phone Number ( ) Date of Birth (mm/dd/yyyy) / / Physician s Name 2 Gender M Health History please check all that apply. F Physician s Phone Number ( ) If you are a new customer or your allergies or health conditions have changed, please indicate all that apply. The information you provide will allow a more complete review of your current medication request. Medication Allergies: None Amoxicillin/Ampicillin Aspirin Cephalosporins (e.g. Cephalexin) Health Conditions: Asthma Heart Condition Other (please specify) None Cancer High Blood Pressure Allergies Seasonal Diabetes High Cholesterol Arthritis Glaucoma Thyroid Disease Please list any over-the-counter or herbal medications you take regularly: 3 Generic Substitution FDA-approved generic equivalents will be dispensed for brand-name medications whenever possible, unless you or your physician indicate otherwise. If you require brand-name medications, please list those medications in the Notes to Pharmacy section below with a brand-name only notation. Note: brand-name medications may be subject to a higher cost. Notes to Pharmacy: 4 Codeine Erythromycin NSAIDs (e.g. Ibuprofen) Penicillin Quinolones (e.g. Ciprofloxacin) Payment and Shipping Information do not send cash. Standard delivery is at no charge. Most orders arrive about 7 days from the date your completed order is received. If clarification of your order is required, delivery may take longer. If you would like overnight shipping, please indicate below. Please note that Ship overnight. Add $12.50 to order amount (subject to change). Check enclosed. All checks must be signed and made payable to Prescription Solutions. Charge to my credit card on file. Charge to my NEW credit card. Sulfa Medications Tetracyclines Other (please specify) New Credit Card Number Expiration Date (Month/Year) / Signature: This credit card will be billed for applicable medications, overnight shipping and outstanding balances. I authorize Prescription Solutions to maintain my credit card on file as payment method for any future charges or outstanding balances. To modify payment selection, please contact Customer Service. Date: PS0762 UHEX _002 Prescription Solutions, P.O. Box 2975, Mission, KS UHEX _001

9 RX OTC Program If you need relief from allergy or stomach acid symptoms, the Rx OTC Program may be right for you. Through the program, your pharmacy benefit plan covers select over-the-counter (OTC) products: Alavert, cetirizine (generic Zyrtec), loratadine (generic Claritin), Prilosec OTC and omeprazole delayed release tablets. These are safe, effective alternatives to similar prescription-only medications. Because OTC medications usually cost less than those you can only get with a prescription, you and your pharmacy benefit plan may save money with Rx OTC. Allergy Symptom Relief If you take a non-sedating antihistamine, such as Allegra or Clarinex, you and your doctor could consider a covered OTC medication instead to treat your allergy symptoms. The following OTC allergy medications are available at your lowest out-of-pocket cost: Alavert, cetirizine and loratadine. Stomach Acid Relief Proton pump inhibitors (PPIs) are a type of medication used to treat stomach acid symptoms. If you take a prescription-only PPI, such as Aciphex, Kapidex, Nexium, Prilosec, Prevacid, Protonix or a generic PPI, the following OTC medications may help lower your costs: Prilosec OTC and generic/store-brand omeprazole delayed release tablets. Participation is as Easy as Talk to your doctor to see if a covered OTC product (Alavert, cetirizine, loratadine, Prilosec OTC, or omeprazole delayed release tablets) is right for you. 2. If you decide to try a medication covered under the Rx OTC Program, ask your doctor to write a prescription for the OTC medication. 3. Take your written prescription(s) and benefit plan ID card to a network pharmacy. The pharmacy will then submit your claim for coverage and collect your copayment as defined by your benefit plan. Getting a Prescription for Rx OTC Medications Although OTC medications are available without a prescription from most local pharmacies and supermarkets, Rx OTC requires you to get a prescription for OTC products covered under the program. Your pharmacy needs the prescription to submit your claim and collect your out-of-pocket contribution as defined by your benefit plan. If you purchase an Rx OTC product without a written prescription, your plan will not cover the OTC medication and you will be responsible for the entire cost. Always talk to your doctor or pharmacist before starting any OTC medication. This is especially important if you take any prescription-only medications or have medical conditions that need your doctor s care.

10 Rx OTC Savings Examples cetirizine savings example Medication Name Average Total Cost per 30-day Rx Prilosec OTC savings example Medication Name Average Total Cost per 30-day Rx Xyzal $81.60 Aciphex $ cetirizine $10.80 Prilosec OTC $23.70 Savings* $70.80 Savings* $ Alavert savings example Medication Name Average Total Cost per 30-day Rx omeprazole del. rel. tablet savings example Medication Name Average Total Cost per 30-day Rx Clarinex $ lansoprazole $ Alavert $6.30 omeprazole DR tablet $39.60 Savings* $ Savings* $ loratadine savings example Medication Name Average Total Cost per 30-day Rx fexofenadine $37.80 loratadine (generic) $6.60 Savings* $31.20 When you use a covered OTC medication, you and your plan sponsor share in the savings, just like in the examples shown above. By paying your plan s lowest copayment, your potential out-ofpocket savings can really add up. Through the Rx OTC Program, your plan saves too, which helps keep the cost of providing your pharmacy benefits more affordable. For questions about the Rx OTC Program or your pharmacy benefit plan, call customer service at the number on the back of your plan ID card. * Savings examples reflect 2009 book of business figures. Comparisons are based on the average adult daily dose Main Street, Irvine, CA PrescriptionSolutions.com PS / Prescription Solutions. This document is proprietary to Prescription Solutions and is subject to federal copyright protection. Any unauthorized reproduction, dissemination or use of this document is strictly prohibited.

11 Half Tab RX Tablet Splitting Through the Half Tab Rx Program, tablet splitting may be a safe, effective way for you to lower your prescription medication costs. To take advantage of the potential savings, your doctor writes a new prescription for double the strength and half the quantity of your current medication. Then, you simply split the tablets in half to safely and easily save up to 50 percent on your prescription costs. Half Tab Rx works because some medications cost about the same, regardless of dosage. For example, the 20 mg and 40 mg dosages of a popular medication used to treat high cholesterol both cost about $80.70 for a 30-day supply. When mg tablets are split, a 30-day supply of 20 mg half tablets costs only $ Splitting the 40 mg tablets effectively cuts the cost of your medication in half. See the following example: Without Half Tab Rx With Half Tab Rx Drug* and Dosage 20 mg 40 mg Number of Tablets 30 (whole tablets) 15 (split in half) Days Supplied Cost Plan: $80.70 You: $20.00 Plan: $40.35 You: $10.00 Annual Savings None Plan: $ You: $ Actual savings vary based on your plan design, but with Half Tab Rx, the savings are real. Helping your plan save money contributes to the overall cost management of your pharmacy benefit plan. *Drug included in this savings example is a popular medication used to treat high cholesterol. To Split Or Not To Split? You are not required to split tablets to save money, but if you choose to participate, to talk with your doctor before splitting any of your medications. If you and your doctor agree that tablet splitting is a safe way for you to save money, you will need: 1. A new prescription from your doctor for the new dosage of your medication. The prescription must clearly instruct you to take one-half tablet daily. 2. A tablet splitting device. Tablet splitters allow you to cut tablets more accurately and safely. You can purchase one for just a few dollars at a local pharmacy.

12 Safe Tablet Splitting Because not all medications are safe to split, our independent review committee of practicing doctors and pharmacists has defined a list of products that are covered under the Half T rogram. Only the medications listed below are eligible for the program. Atacand fosinopril (Monopril) Avapro lisinopril Zestril) Cozaar metoprolol ER (Toprol XL) restor paroxetine ( axil) ovan pravastatin ravachol) Lexapro quinapril (Accupril) tor sertraline (Zoloft) benazepril (Lotensin) simvastatin (Zocor) citalopram (Celexa) zolpidem (Ambien) doxazosin (Cardura) 2300 Main Street, Irvine, CA 926 rescriptionsolutions.com 02/ rescription Solutions. This document is proprietary to rescription Solutions and is subject to federal copyright protection. Any unauthorized reproduction, dissemination or use of this document is strictly prohibited.

13 Welcome to Prescription Solutions Specialty Pharmacy We re Here to Help Specialty pharmaceuticals are some of the true wonder drugs in medicine today. Because treatment with these unique products can sometimes be an intense experience, the Prescription Solutions Specialty Pharmacy does more than fill your prescriptions. We also provide you and your prescriber with a team to support you throughout the course of your specialty medication therapy. Program Features Your Treatment Team: Patient Care Coordinators (PCCs) are your primary contacts at Prescription Solutions Specialty Pharmacy. They will check in with you to schedule deliveries and help manage your inventory of medication and supplies. Our Registered Pharmacists will also actively participate as members of your treatment team, reviewing lab results, monitoring compliance and checking for side effects or drug interactions. If necessary, they will also recommend treatment adjustments to your prescriber. Copayments: Copayments must be made before your order can ship. Credit cards are preferred and may also be more convenient for you. We can securely file the number (with your permission) to charge future refills to the same credit card. Orders and Refills: When you re on an intensive drug therapy, it s critical to receive your refills in a timely manner. That s why a PCC will contact you about a week before each shipment. In addition to scheduling your deliveries, the PCC will check to see if you need any additional supplies and answer any questions you may have. Deliveries: All specialty pharmaceuticals are shipped at no charge to you. Refrigerated specialty pharmaceuticals are shipped overnight, with scheduled deliveries Tuesday through Friday. Non-refrigerated items are shipped via ground delivery. Orders can be shipped either to your doctor s office or your home, depending on who administers your medication. Disease Therapy Management (DTM): DTM provides an enhanced level of care for certain medical conditions treated with select specialty pharmaceuticals. If you are eligible to participate in a DTM program, specially trained nurses and pharmacists will contact you regularly via telephone with additional care and support. If you fill a prescription for a specialty medication with an available DTM program, you are automatically enrolled. See the enclosed flyer for a complete list of available DTM programs, or call (TTY 711). Contact Information If you require assistance with refill orders, prescription transfers, benefit questions, payment options, service or supply concerns, delivery updates or therapy changes, please call us. You can reach Prescription Solutions Specialty Pharmacy at (TTY 711). We re available from 6 a.m. t p.m. Pacific Time, Monday through Friday. On-call pharmacists are available 24-hours a day, 7 days a week. Our telephonic device for the hearing impaired (TDHI) number is Visit us online at Main Street, Irvine, CA PS0 / Prescription Solutions. This document is proprietary to Prescription Solutions and is subject to federal copyright protection. Any unauthorized reproduction, dissemination or use of this document is strictly prohibited.

14 Free Meter Program Diabetes can affect the eyes, kidneys, nerves and cardiovascular system. The impact of these complications could be long-term, but regular blood sugar testing can help. Testing not only helps you avoid such health risks, but can also prevent life-threatening conditions caused by very high or very low blood sugar. Our Offer to You To help you monitor blood sugar levels regularly, your pharmacy benefit plan may include the Free Meter Program. Through this program, you may be eligible to receive a blood sugar meter at no charge to you. The program includes four different meters you and your doctor can choose from. More information on each meter is included on the next page. For additional details, you can also contact Prescription Solutions customer service at the phone number on your benefit ID card or ACCU-CHEK or Bayer HealthCare using the numbers provided below. How To Get Your Free Meter The first step in every diabetic care plan should be talking with your health care team. If you are interested in getting a new blood sugar meter, share this communication with doctor or diabetes educator. They can help determine which no-charge meter is right for you. After choosing the covered meter you ll use to regularly test blood sugar levels, it s easy to place your order. Just call the manufacturer s service center any time: ACCU-CHEK meters: Call the ACCU-CHEK Fulfillment Center at Bayer HealthCare meters: Call the Bayer HealthCare Fulfillment Center at

15 Available Meters ACCU-CHEK Aviva Meter AC e e-prov s 1 sy- e k es s k 0 s F r r T s r SA 2 ov y ov ho s y ACCU-CHEK Compact Plus Meter r es s e e e sy- o-r ov y ov ho s y Bayer s BREEZE 2 Meter C Co v sy- es s R s e Bayer s CONTOUR Meter C Pr k o es r or v A es r e r y r es F s es 1 s r v sys e 2 r S S r e 926 r. 02/ Pr T pr o Pr o r opyr h pro e o. A y hor e repro o, sse o or se o h s o e s s r y proh e. A reserv

16 Wise Choice Rx The Wise Choice Rx Program helps you and your plan sponsor get the most from your pharmacy benefit plan. Through the program, a pharmacy benefit representative works with you to identify and use money saving options that are already part of your plan. Wise Choice Rx takes the mystery out of understanding your plan, and it s available at no additional cost to you. Personalized Benefit Consultation When you contact us, your pharmacy benefit representative schedules a time for your personalized benefit consultation. Before your appointment, the representative reviews your pharmacy benefit claims history to identify the medications you currently use. The representative then checks which programs are part of your benefit plan and determines if you can use any to pay less for your medications. During your one-on-one consultation, the representative shares the findings with you and helps you start using the programs that are right for you. The following programs may be reviewed during your consultation depending on your specific plan s benefit design: Generics: Generics offer the same quality and effectiveness as brand name products, but are typically less expensive. Preferred Products: Medications on the Preferred Products List cost less than others you may be taking. Mail Service Pharmacy: With mail service, you may save money and get up to a 90-day supply of medications delivered to your mail box with no charge for standard shipping. Tablet Splitting: You may be able to safely split tablets of select medications to save money without decreasing how well the medication works for you. Rx OTC: Certain over-the-counter medications are less expensive and may be covered by your benefit plan. Save Plan Expenses Contacting Wise Choice Rx is also good way to help your pharmacy benefit plan sponsor manage costs. The programs reviewed during your personalized benefit consultation usually save money for both you and your plan. By just using the money saving programs already built into your plan, you help keep the cost of providing your pharmacy benefit coverage more affordable.

17 Get Started with Wise Choice Rx To schedule your personalized benefit consultation, contact Wise Choice Rx at We re available Monday through Friday, 7 a.m. to 6 p.m. CT. Information provided to you through the Wise Choice Rx Program is intended to educate you about cost savings measures under your pharmacy benefit plan. It is not intended to substitute for the professional medical advice, diagnosis or treatment of a physician, pharmacist or other health care professional. Always seek the advice of your physician or other qualified health provider regarding any questions you may have about a medical condition or a prescription. If you think you have a medical emergency, call your doctor or 911 immediately Main Street, Irvine, CA / Prescription Solutions. This document is proprietary to Prescription Solutions and is subject to federal copyright protection. Any unauthorized reproduction, dissemination or use of this document is strictly prohibited.

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