Caterpillar Open Formulary

Welcome to the Caterpillar Prescription Drug Benefit Search Tool

This search tool applies to certain production hourly Retirees in a plan administered by UnitedHealthcare.

AND who retired before:

• Central Labor Agreement - 4/1/2011 (who did not elect to participate in the management plan)
• Joliet - 8/20/2012
• Mapleton Patternmakers - 10/1/2012

How to Search for Drugs

• Use the alphabetical list to search by the first letter of your medication.
• Search by typing part of the generic (chemical) and brand (trade) names.
• Search by selecting the therapeutic class of the medication you are looking for.

Health Care Reform (HCR)

The list includes preventive care medications covered in accordance with the Patient Protection and Affordable Care Act (ACA), as modified by the Healthcare and Education Reconciliation Act of 2010. Certain preventive care medications are covered at 100% by the plan if you use an In-Network Pharmacy. If you use an Out-of-Network Pharmacy, you will be subject to the applicable co-pay. These medications are labeled as ‘HCR’ on this formulary listing. For additional information on preventive care medications covered by the plan, visit: healthcare.gov/center/regulations/prevention.html or uspreventiveservicestaskforce.org

Diabetic Supplies & Insulins

The following over-the-counter (OTC) diabetic supplies and Insulins are covered under the prescription drug benefit with a valid prescription from your provider.

Contour Next and FreeStyle test strips are preferred. Your plan offers a Free Meter Program if you switch to Contour Next or FreeStyle Test Strips.

• Have your pharmacy process your Ascensia Diabetes Contour meter through RxBIN# 018844, PCN# 3F, Group ID# MGDCARE, ID# CNMC7246982. OR Call 1-800-401-8440 and mention ID Code for your BDC-PTS free meter (limitations or restrictions may apply).
• Have your pharmacy process your FreeStyle meter prescription through RxBIN# 610020, Group# 99992432, ID# ERXACTMETER.

Product Description	Tier	Limits & Restrictions
Insulin Syringes	1
Lancets	1	QPD-Quantity Per Day
Glucose Meters
Contour	2	QL-Quantity Limit
FreeStyle	2	QL-Quantity Limit
All Other Brands	3	QL-Quantity Limit
Glucose Test Strips
Contour Next	1	QPD-Quantity Per Day
FreeStyle	1	QPD-Quantity Per Day
All Other Brands	3	QPD-Quantity Per Day
Insulins
HUMULIN 70-30 VIALS HUMULIN N VIALS HUMULIN R VIALS NOVOLIN 70-30 VIALS NOVOLIN N VIALS NOVOLIN R VIALS	1
HUMULIN 70-30 KWIKPEN HUMULIN N KWIKPEN HUMULIN R KWIKPEN NOVOLIN 70-30 KWIKPEN	3

Additional Information

Please refer to your summary plan description (SPD) provided at catatwork.cat.com.

If you have questions about your prescription drug coverage, you can also call Prime Therapeutics Customer Service toll-free at 1-877-228-7909 24 hours a day, 7 days a week.

The information regarding alternatives is not intended and should not be construed, in any way, as medical advice, opinion, diagnosis or as advice about the treatment of any specific medical condition. You should consult with your physician regarding your particular health needs and whether any of the alternative treatments are right for you. In the event that the content of this document or any representations made by any person regarding the plan conflict with or are inconsistent with the provisions of the plan document, the provisions of the plan document are controlling. To the fullest extent permitted by law, Caterpillar reserves the right to amend, modify, suspend, replace or terminate any of its plans, policies or programs, in whole or in part, at any time and for any reason, by appropriate company action.

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