Retiree Welfare Plan Medicare Prescription Drug Plan

Effective January 1, 2021, a new prescription drug plan went into effect that covers all Medicare-eligible retired members and their Medicare-eligible spouses and dependents. This plan is called Midwest Operating Engineers Retiree Welfare Plan Medicare Prescription Drug Plan (RWP Medicare PDP) and is administered by the Midwest Operating Engineers Welfare Fund along with OptumRx®, our current Pharmacy Benefit Manager.

The RWP Medicare PDP combines a standard Medicare Part D prescription drug plan with additional coverage provided by the RWP. This additional coverage is referred to as a wrap plan because it wraps around the standard Part D plan and closes the gaps between Part D and your current coverage. This means that you have more coverage than the standard Medicare Part D plan.

If your spouse or dependents are not eligible for Medicare, but are eligible under the RWP, they have coverage under the current Prescription Drug Program currently in place for the RWP, click here for more plan information.

Options for Filling a Prescription
You must use a pharmacy that is in the OptumRx network to receive plan benefits. The OptumRx network includes more than 67,000 pharmacies nationwide, and you will pay the same copayment for your prescription drugs at any network pharmacy. The RWP Medicare PDP allows you to get your prescriptions filled in 2 ways.

Option 1: Fill your prescription at your local retail pharmacy.
• The plan allows you to receive a 30-day supply or up to a 90-day supply of prescription medication at any OptumRx network pharmacy. Simply take your RWP Medicare PDP ID card, along with your prescription, to a network pharmacy. If you go to a network pharmacy, you will only pay your copayment. You are no longer required to fill a 90-day supply of your maintenance medications.

Option 2: Fill your prescription with Home Delivery (prescription mail-order service).
• The plan also allows you to receive long-term maintenance medications through Home Delivery. Home Delivery offers a convenient and cost-effective way to get up to a 90-day supply of maintenance medication through the mail.

The RWP Medicare PDP features a 4-tier prescription drug benefit. Below is a chart showing the copayment amounts that you will be required to pay for your Medicare prescription drugs.

RWP Medicare PDP Formulary List

A formulary is the list of covered drugs covered by the Medicare Part D portion of your plan. These drugs were selected by RWP Medicare PDP in consultation with OptumRx and a team of healthcare providers and represent the prescription therapies believed to be a necessary part of a quality treatment program. This plan will generally cover the drugs listed in our formulary as long as the drug is medically necessary, the prescription is filled at an OptumRx network pharmacy, and other plan rules are followed.

Additional Coverage provided by the RWP

The RWP Medicare PDP Formulary is the list of covered drug used by the RWP Medicare PDP for the Medicare Part D portion of the plan. The additional coverage provided by the RWP is also referred to as a wrap plan because it wraps around the Medicare Part D portion of the plan to cover drugs not on the formulary. These drugs include Part D drugs not included on the formulary, as well as some drugs not covered by Medicare Part D, such as:

  • Prescription drugs when used for anorexia, weight loss or weight gain
  • Prescription drugs when used for the symptomatic relief of cough or cold
  • Prescription vitamins and mineral products not covered by Medicare Part D
  • Prescription drugs when used for the treatment of sexual or erectile dysfunction

Billing Information

Please be sure to present your OptumRx MedicareRx ID card to your local pharmacist when dropping or picking up a prescription.

If you have a spouse or dependent(s) enrolled in this prescription drug plan who is eligible for Medicare Part D, they were mailed their own ID card when Medicare approved their enrollment so it is critical that everyone uses their own OptumRx MedicareRx ID card.

If you have any questions about this plan’s benefits or costs, please call OptumRx Member Services toll free at 1-866-868-2493, TTY 711, 24 hours a day, 7 days a week.