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Disease Management Programs
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Disease Management Programs
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Drug Use Review Program.
In June 2006, the Lucas County Health Care Cost Containment Board (LCHCCCB) recommended to the Board of Lucas County Commissioners that an expanded prescription drug use review program be made available through several local independent pharmacies on a trial basis.
Lucas County enrollees taking two or more prescription drug maintenance medications, enrollees experiencing medication side effects, or not feeling well should enroll in this program.
Incentives to participate include:
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A 90-day supply of Tier I and Tier II prescription medications at the SAME co-payment cost as the mail order program.
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Each enrollee who completes the program receives $50.00 worth of coupons toward their prescription drug co-payment at the participating pharmacy.
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Enrollees who complete the program will have their annual out-of-pocket maximum for Tier II brand name medications limited to $350.00/year and a $500.00 out-of-pocket maximum for Tier III except for Enbrel.
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For patients with diabetes, 100 free test strips and lancets are provided for each month. Your blood sugar readings will also be reviewed, recorded and results forwarded to your physician, upon request.
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If an enrollee has four (4) Tier II brand name medications, each costing $25.00 in co-payments per month through the mail order program, they will spend $400.00 in twelve months. If that same enrollee completes this program, they will be limited to an out-of-pocket maximum of $350.00— a savings to the enrollee of $50.00.
You, your eligible spouse, and dependent children enrolled in the prescription drug plan through the county are eligible to participate. The program duration is twelve months from the date of the initial session. There is no cost to participate.
This expanded program is provided through the following local pharmacies:
| Erie Drug |
4502 Lewis Ave. |
Toledo, OH |
419-476-4322 |
| Kahler Pharmacy |
1941 Airport Highway |
Toledo, OH |
419-382-2911 |
| Ryan Pharmacy |
3340 Dorr St. |
Toledo, OH |
419-531-2836 |
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| The Pharmacy Counter |
2655 W. Central Ave., 2701 Navarre Ave., or 1544 Byrne Road |
Toledo, OH |
419-382-3475 |
Services available to those who enroll in the program include:
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Regular private sessions with a pharmacist to discuss your medications, supplements, and over-the-counter drugs.
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During each visit to the pharmacist or nurse, your blood pressure will be taken and your cholesterol and blood glucose levels will be checked.
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Certain participating pharmacies have agreed to forward your test results to your physician directly. This may save you the cost of a lab test when you visit your physician.
NOTE: Tier III medications are not available with a 90-day supply.
Patients most at risk are those who have multiple physicians prescribing medications. Patients currently using the mail order program may benefit from routine access to a pharmacist and other medical professionals. While enrolled in Drug Use Review, the mail order program is suspended.
No pharmacists can alter or override a prescription. Only your physician can change your medication. This process is not intended as a substitution for the professional judgment of the prescribing physician or any other health care professional providing services to you.
Some County elected officials have agreed to allow up to an
hour of work release time for the initial session. If you use work release time for the initial session, you must show documentation of attendance from the participating pharmacy Please check with your employer for their
participation regarding the work release time.
Questions about the program may be directed to the participating pharmacies listed on this page, or the Risk Management Department at 419-213-4531 or 419-213-4211.
Diabetes Case Management Program - This program consists of an initial nutrition education program and periodic session with a participating community pharmacist. There is no cost to participate in these programs. Enrollees who participate in this program are eligible for 100% reimbursement for approved nutrition education programs and up to 100 lancets and test strips per month through the Prescription Drug Plan.
Cardiac Rehabilitation Program - Enrollees participating in Phase III and IV of an approved Cardiac Rehabilitation Program will be reimbursed at 100% of the program cost upon fulfillment of the terms of the Lucas County Wellness Program Performance contract. Reimbursement is not limited to the maximum amount of $400.00 covered per person each year.
Smoking Cessation Program - The Wellness Program reimburses 100% for smoking cessation classes and one two-week supply of nicotine patches or nicotine gum upon completion of the program and satisfaction of the terms of the Lucas County Wellness Program Performance Contract. For more information and to make a reservation, call one of the following hospitals:
1. St. Charles Hospital at 419-696-7350
2. Toledo Hospital at 419-291-8033
3. St. Vincent Mercy Medical Center at 419-251-3232
4. St. Luke’s Hospital at 419-897-8449
The Wellness Program also provides reimbursement for acupuncture and/or hypnosis classes. You are covered for a two time maximum reimbursement of $195.00 per person.
Weight Loss Medications - Persons 60% over their ideal body weight can meet with a Health Coach once a month and develop a plan to encourage and participate in a lifestyle change. As a participant, you will be reimbursed 100% for weight loss medications for a maximum of 6 months in a lifetime, but only under strict physician supervision.
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