DEA Registered Users Only

 

 

 

 

 

Members can view PDF by registering for Website.

GHI and HIP announcement letters that Emblem Health will be mailing out.  Click on links to view.

 

 

The member, his or her spouse, and children (up to their 26th birthday) can use the Benecard PBF drug card at participating pharmacies with a co-payment schedule as follows:

$ 0 (zero) for generic medications

25% for preferred brand name medications

50% for non-preferred brand name medications

45% for ALL brand name psychotropic and asthma medications

If a member obtains a brand name drug that has a generic available, he or she will also pay the cost difference between the brand name and the generic.

A Step Therapy Program has been implemented effective January 1, 2014 for all therapeutic drug categories including specialty medications. This program applies only to new prescriptions for medications requiring step therapy.

 

Prescription drugs that have an over-the-counter equivalent are not covered under our drug plan.

In accordance with the Patient Protection and Affordable Care Act (PPACA) dependent children from the ages of 19 to the date of their 26th birthday may use the Benecard PBF card to obtain their prescriptions, and simply pay the co-payment. Dependent student verification is no longer required for prescription drug benefits under PPACA.

Please note: Dependent student verification IS required for all other (non-prescription drug) DEA health benefits that are classified as "non-essential" under PPACA. As such, children from the ages of 19 to the date of their 23rd birthday (who have proper student verification on file with the DEA) will be covered for these benefits. Student verification must be submitted to the DEA Health Benefits Office twice each year for the fall and spring sessions. Please remember to submit student verification for the fall semester (which covers the time period between 9/1 and 2/28), and the spring semester (which covers the time period between 3/1 and 8/31). Click here for DEA Student Verification Form.

Mail order -- The maintenance (continuous medication) drug program entitles you to a three (3) month supply with a co-payment schedule per prescription as follows:

$ 0 (zero) for generic medications

25% for preferred brand name medications

50% for non-preferred brand name medications

45% for ALL brand name psychotropic and asthma medications

If a member obtains a brand name drug that has a generic available, he or she will also pay the cost difference between the brand name and the generic.

 

Effective August 18, 2014, Specialty medications are no longer covered under our Active members drug plan.  Active members who utilized specialty medications on or prior to June 19, 2014 were grandfathered for those medications only and will continue to be covered under the DEA prescription drug plan.  The same 25% and 50% co-payments will apply for preferred and non-preferred specialty medications, respectively.

Effective January 1, 2014, once the prescription drug spend reaches $10,000 per calendar year per family, all medications (both brand and generic) will be covered at 50%. Members with individual coverage will have a $6,350 annual out of pocket maximum. Members with family coverage will have a $12,700 annual out of pocket maximum. Once out of pocket maxima are reached, the DEA will cover 100% of the cost of the medication.

In addition, with the inception of the Patient Protection and Affordable Care Act (PPACA), certain preventative drug categories will now be covered with certain restrictions. Please refer to the Benecard benefit summary mailed to your home for further details.

You may contact Benecard PBF directly at 1-888 DEA NYPD or the DEA health benefits office should you have any questions regarding your prescription drug benefits.

The City of New York is covering certain prescriptions (injectibles and chemotherapy drugs) under the PICA program. This program is available to all non-Medicare members who are enrolled in a City-sponsored Health Plan. The benefit is administered by Express Scripts and requires the member to present their Express Scripts PICA card at the pharmacist. Contact the DEA office or call Express Scripts at (800) 467-2006 for more information. You may also visit Express Script's web site at www.express-scripts.com

Click here to download the Benecard Services Direct Reimbursement Claim Form

Click here to download the Benecard PBF Mail Order Form

LINE OF DUTY PRESCRIPTION DRUG PROGRAM

The NYPD Medical Division assumes the responsibility for payment of prescription medicines related to "approved" line of duty injuries for active uniformed Members of the Service. The program is administered by Envision RxOptions Incorporated and there are no co-pays or deductibles for injured members concerned.

Injured members can receive free prescription medication for their line of duty injuries by –

1.Ascertaining the complete ten digit "line of duty injury" number from the approved LOD report that relates to the prescription required for that injury.
2.Obtain the "line of duty" prescription paper card from the LOD package and enter on the card your tax registry number and the ten digit approved line of duty number.
3.Present to the participating pharmacy your prescription along with the "line of duty" program card bearing your tax registry number and the line of duty number.
4.Present to the pharmacist your NYPD identification card.

NOTE – There is no need for any pharmacist to copy your NYPD identification card in order to fill your prescription!

Members should familiarize themselves with NYPD Operations Order # 36 of 2008 for details.

Here are some frequently asked questions:

Q. Who can use the Line-of-Duty Prescription Program?

A. Only uniformed members of the NYPD who are still active and who have sustained an "approved" 
 line of duty injury, and have a valid prescription from a licensed practitioner for medication(s) 
to treat that injury.

Q. What do I need to use the Line-of-Duty Program?

A. Four items are needed to utilize the Line-of-Duty Program:

1.The Member's six digit tax registry number; 
2.A valid 10 digit Line-of-Duty Injury Number (specific to the injury that requires medication); A Line-of-Duty Prescription Program Card (fill in the 16 digit card-holder number with your tax registry number plus your Line-of-Duty Injury number); and
3.The valid prescription intended to treat the Line-of-Duty injury.
Q. Are there any restrictions or limitations to the Line-of-Duty Prescription Program?

A. Yes:

1.The Line-of-Duty Prescription program is a mandatory generic drug program. If a generic drug is available, then the brand name drug is not covered; 
2.An initial five (5) day supply is limited for high cost medications; 
3.Other clinical and cost containment safeguards are administered (quantity limits, step therapy, prior authorization, refill too soon, drug to drug interactions, etc.).
Q. Who can I call if I have questions about the Line-of-Injury Prescription Program?

A. Uniformed Members of the Service who require help or guidance with any aspect of the Line-of-Duty
 Prescription Drug Program can contact the following:

1.Envision Rx Options' 24-hour help desk at 1 (866) 909-5167;

2.The Medical Division's Line-of-Duty Prescription Drug Unit, Monday through Friday, from 07:00 to 18:00 hours, at (718) 760-3029 or (718) 760-3059;

3.The Medical Division's Sick Desk Supervisor (24 hours per day) at (718) 760-7606.

Q. Where can I get a Line-of-Duty Prescription Program Card?

A. Blank cards are not individual specific and are available at the following:

1.The Medical Division;

2.Via fax by contacting Envision Rx Options' 24 hour help desk at 1 (866) 909-5167;

3.On the NYPD intranet website at www.nyc.gov/nypd in the "Finest Health" link (user name is "finesthealth" and password is "stayhealthy");

4.Download a copy of the card by clicking on this link. Card may be printed from your computer and/or photocopied

A member must select from one of the following dental plan options:

PLAN ONE – COMPREHENSIVE PANEL PROGRAM

An enrollment card is needed for this program. The member selects a panel dentist whom the entire family is required to use. You must use this dentist only. There are no dental forms to submit.

Please note that enrollments for this plan are done monthly. If the application is received by the 15th of the month, it will be effective the first of the following month.
 


 

PLAN TWO – FEE SCHEDULE PLAN click here to download dental forms

Participating Dental Providers

Choose a dentist from the DEA participating provider listing. These dentists have agreed to accept Healthplex's DEA schedule as payment in full for covered services. Healthplex will pay these providers directly. You are not responsible to pay these participating dentists for covered services.

* * * * * OR * * * * *

Non Participating Dental Providers

The member may choose any dentist he or she prefers and pay the dentist directly for services. The member is reimbursed for covered services only according to the DEA fee schedule of allowances.

Please note: DEA members who are enrolled in the Comprehensive Panel Program are not permitted to use the providers under the Fee Schedule Plan.

The DEA has instituted a new optical program for active members.

Davis Vision is the exclusive optical provider for active DEA members and their dependents.

The Davis Vision Optical Plan provides DEA active members with uniformity and a wide selection of "up-to-date" progressive prescription eyewear which is available at each of the optical centers in the extensive Davis Vision network of independent providers. Many designer frames for children are available through this plan as well.

Effective January 1, 2010 members have the opportunity to select ANY frame in the Davis Vision Collection which includes Fashion, Designer and Premier frames with retail values up to $225.

The DEA's goal is to deliver a plan that drastically reduces (or eliminates altogether) the high member out-of-pocket costs associated with current state of the art eyewear as well as comprehensive eye examinations.

The plan offers a thorough eye exam and a pair of glasses to members and their dependents once every 12 months.

Effective January 1, 2010 there are no co-payments required for plan contact lenses and the supply has been increased to one full year for disposable contact lenses. The benefit allowance for non-plan contact lenses has also been increased to a $60 credit at all in-network providers.

In order to provide additional convenience for our members, eligibility will be determined electronically, thereby eliminating the need for DEA-issued vouchers. Simply provide your participating Davis Vision provider with your unique DEA identification number located on your DEA Vision Benefit Card. The plan also features a one year guarantee for broken frames, and other benefits as well.

Any questions can be answered by contacting the DEA Health Benefits Office at (212) 587-9120, or by calling Davis Vision directly at 1 (800) 999-5431...

Or click here to connect with DavisVision.com 

The DEA provides a hearing aid benefit to all eligible active members and their eligible dependents.

When prescribed by a licensed physician, the DEA will reimburse up to a maximum of $500 per ear device every four years. For active members' dependent children, the benefit will be available every two years.

The benefit does not cover the exam, repairs, batteries, ear molds, or service contracts.

A claim form may be obtained at the DEA Health Benefits office, or go to "forms" section of this website to download a PDF version.

The DEA provides HIP members an additional rider benefit that covers Private Duty Nursing and Appliances.

Inner Imaging is at 307 East 63rd Street in Manhattan. To schedule an appointment, call (212) 777-8900 -- but first, read through the following information and the information on their web site, linked at the end of this article. Also see, at the end of this story, The Chief-Leader newspaper article from their June 8, 2007 issue. 
 
 



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Since the attacks on the World Trade Center, and the rescue, recovery, and clean-up efforts that followed, many of our members have become ill from an assortment of ailments, including respiratory problems, cancers, and other diseases that vary in magnitude.
 
While the DEA has been promoting the work of the WTC Medical Screening Program at Mt. Sinai and the Mental Health and Substance Abuse Program of the American Red Cross, we feel a more pro-active course needs to be taken. 
 
Therefore, in conjunction with Inner Imaging, an affiliate of the Heart Institute at Beth Israel Medical Center, the Board of Trustees of the DEA have created an arrangement for a deeply discounted price for a medical screening examination for DEA members.
 
The DEA has been successful in negotiating a deeply discounted price for a "body scan" — an exam which includes four tests: for the heart, the lungs, the abdomen, and the pelvic area. While the price for this full body exam is approximately $850, the DEA has been able to reduce the price for our ACTIVE members to $375.
 


For active members, the DEA will subsidize $200 of that cost. Therefore, active members will pay only $175 for this one-time, members-only body scan.
 
 
The importance of this scan is that it can detect, at early stages, those factors which can lead to seriously debilitating or even fatal disease. We hope that this $850 value for only $150 will act as an incentive for our members to take advantage of this important preventative program: our goal is to keep our membership healthy and to save lives. 
 
Below, please find some basic facts concerning these medical scans.
 
To pursue your body scan, call the DEA Health Benefits Office at (212) 587-9120and our staff will explain the process to you. Inner Imaging has also created an on-line scheduling method exclusively for DEA members at www.savenycdetectives.com
 
 
 The DEA Board of Trustees feel strongly that this procedure can be of great benefit to your health and welfare, and that is why we stress its importance as we go forward in dealing with the unknown ramifications of the medical effects of 9/11.
 


CORONARY ARTERY DISEASE
 
 Police work is a highly stressful profession and we all know how much stress can affect the heart and play a contributing role in heart attacks. More than 1.5 million people suffer heart attacks each year, and over 30% of those attacks are fatal. Coronary artery disease is a leading cause of those attacks. 68% of these sudden heart attacks are in arteries that are less that 50% blocked and that blockage cannot be detected with traditional stress testing. Inner Imaging believes its heart scan can identify coronary artery disease as much as 15-17 years before symptoms occur with an accuracy rate of 98%.
 
 


LUNG CANCER
 
 Lung cancer is the leading cause of cancer deaths in the United States. In light of 9/11 and the toxic substances our members have been exposed to, we are extremely concerned about respiratory illness. Electron Beam Tomography scanning (EBT) is ten times more sensitive than a regular chest x-ray and can detect the early development of lung diseases. The current survival rate of lung cancer is only 12-15%. Inner Imaging believes that early detection of lung cancer with EBT scanning can potentially change the survival rate to greater than 80%.
 
 
 ABDOMEN AND PELVIS
 
 There is a spike in some organ cancers found in those who were involved in the rescue, recovery, and clean-up efforts of 9/11 and in those who worked at Ground Zero, the landfill, and the morgue. The abdomen and pelvis exams are used to identify early stages of disease in the organs of your abdomen and pelvis areas, such as the liver and intestines
 


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Reprinted with permission from The Chief-Leader newspaper, June 8, 2007 edition.
 
 
 NYPD Cops at Greater Risk of Heart Disease; DEA Program Finding More Damage Than In General Public
 
 By REUVEN BLAU
 
 Initial results from a unique heart‑scan testing system have shown that Detectives and other NYPD officers have exhibited increased signs of coronary artery disease at a younger age than the general population.
 
 Based on prior data, 2 percent of men under 40 showed some level of plaque or calcium buildup in their hearts, according to Inner Imaging, which is affiliated with Beth Israel Medical Center. In contrast, 17.7 percent of the 2,000 Detectives screened with the Electron‑Beam CAT Scan since last summer have displayed artery ailments, Inner Imaging officials said.
 
 Earlier and Worse
 
 "It is starting earlier and much more aggressive," said Albert E. Barrette, the managing director of Inner Imaging.
 
 The test, called the Imatron Ultrafast Electron Beam Scanner, has the ability to "predict heart attacks," he added. Several of the city's uniformed unions are following the Detectives' Endowment Association's lead and offering the screening to their members at a reduced price.
 
 The medical field, however, has been slow to embrace the new technology. "Most of the negatives are pure ignorance," argued Mr. Barrette, who has tested himself four times. "It's just such a difficult struggle trying to separate ourselves."
 
 The Fire Department and practically all the city's cardiologists have generally

PREVENTIVE SCREENING

HEARTSCAN SERVICES INC. CARDIOVASCULAR AND THYROID SCREENING ROGRAM

In our continuing effort to track the latest innovative technology and provide trulycomprehensive health screening programs for our members, the DEA is proud to share with you news of our partnership with Heartscan Services; a non-invasive,mobile cardiovascular and thyroid screening company.

Statistics show that heart disease is the #1 killer and stroke is the #3 killer of people in the United States. Every 60 seconds someone in the U.S. dies of a heart attack and every 40 seconds someone has a stroke. These diseases are preventable if detected and treated early. Most people are symptom free and therefore most insurance companies will not cover the tests that identify their risk.

Thyroid Nodule Screening can identify early the potential risk for thyroid cancer. Thyroid cancer is the fastest increasing cancer in the United States and particularly for our first responders.

New York cops' cancer rate soaring in wake of 9/11 -Daily News 9/30/13

Summary

•Tenfold increase in cops diagnosed with thyroid cancer an NYPD study shows

•Thyroid cancer shows up late in terms of symptoms and they aren't easily found during self-exams

•Dr. Eli Kleinman, chief surgeon for the NYPD states: "cops to carefully watch their health, since cancers that have been afflicting more of them have no symptoms until it's too late".

•Commissioner Ray Kelly to cops: 'GET YOURSELF CHECKED OUT.'

ABOUT THE SCREENING:

The cardiovascular and thyroid nodule screening is a simple, painless, non-invasive, ultrasound package that can evaluate your risk for Cardiovascular Disease, Stroke, Peripheral Arterial Disease, and Thyroid nodules. There is no preparation needed for the screening.

•ECHOCARDIOGRAM - looks at size, shape and movement of the heart.

•CAROTID ARTERY ULTRASOUND - can identify plaque in the carotid arteries which can lead to stroke.

•ABI INDEX (ankle brachial index) - looks for peripheral arterial disease and early diabetes.

•Thyroid Nodules- can identify the potential risk for thyroid cancer. Thyroid cancer is the fastest growing cancer in the United States.

DEA ACTIVE MEMBERS AND FAMILY DISCOUNT

We have negotiated the following discounted prices for all Active DEA members and their families:

•CARDIOVASCULAR AND NODULE SCREENING - UNION PRICE - $199 (normally $300).

Heartscan Services is HIPAA compliant and all results are strictly confidential.

Heartscan Services is mobile making it convenient for all to take advantage of this program. Designated screening locations throughout the New York Metropolitan area, Upstate New York and New Jersey area will be made available by Heartscan Services.

WWW.HEARTSCANSERVICES.COM 

To schedule an appointment: 1-866-518-1112

EARLY DETECTION SAVES LIVES!

AFLAC Logo

Optional and at the Members' Expense

The DEA has entered into an agreement with Aflac New York to offer supplemental coverage to all DEA members for an Accident Policy, Cancer Protection Policy, Dental Supplement, and/or Hospital Protection Policy.

If you need further information or are interested in enrolling, contact the following Aflac New York Agents:

Stephen DeMaria           Joseph Pernice

Cell 917-848-8334         917-886-7215

Office 212 679-9807      Fax 212 658-9662

Toll Free (800) 564-2775

Aflac polices are purchased via payroll deduction.

Aflac has the finest Specified Disease Cancer Protection policy, one that pays cash benefits directly to policyholders. The rates are the same for all active members. It is portable and can be carried with you at retirement at the same group rates with no increase. We highly recommend you consider this policy.

The attached PDF file is the Aflac Payroll Election Form for DEA Members.

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