How OU Health Works with Medicare

How OU Health Works When You are on Medicare

When a member and/or spouse become Medicare eligible, it is very important that they contact Medicare to determine their enrollment needs. Failure to do so at that time could be very costly down the road.

Once an OU Health member is retired or no longer working and on Medicare, you no longer have to be concerned about your provider/facility being a Blue Cross Blue Shield provider. Instead, you must be sure that any healthcare provider/facility you use accepts Medicare. Medicare becomes your primary medical coverage and OU Health becomes secondary (there are a few exceptions, please see the Plan Document for further information). OU Health will pay 80% of the balance after Medicare has paid. You will be responsible for paying the balance of 20% after you have met your annual deductible. However, do not pay any balance of a bill until you have received a bill from your healthcare provider/facility.

Prescription Drug Benefits

OU Health provides a Medicare Part D wrap for prescription drug coverage that maintains your current benefits and copays. You will have a separate prescription drug card that you will use at your local pharmacy or mail order and specialty drug services. There may be instances when your prescription drug copay will be less than what your copay previously had been.

Do not enroll in Medicare Part D! OU Health will do this for you automatically.

Latest News

The OU Health Plan has arranged with EmpiRx to offer the flu vaccine to Plan members for a $0 copay

To receive your FREE Flu Vaccine, COVID-19 vaccination or COVID-19 booster shot simply go to any participating pharmacy and present your OU Health member ID card.


To receive your Free Flu Vaccine or COVID-19 vaccine or booster shot, simply go to any pharmacy that participates with the CVS Caremark/ Silver Script network of pharmacies and present your Silver Script Prescription ID card.

Note to all members: This year, please consider obtaining the flu shot in October, before the flu season starts, as medical experts have advised co-exposure to both COVID-19 and the flu could result in serious illness such as pneumonia and respiratory distress, hospitalization or even death. This is possible because the flu and COVID-19 are caused by different viruses.

***OU Health announces EmpiRx Health as the new Pharmacy Benefits Manager effective July 1, 2021***

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The Orange Ulster School Districts Health Plan will provide 100% coverage for in-network diagnosing and laboratory testing for the potential Corona Virus office visit or Live Health Online (Telemed) visit. Click here to download

Friday,March 8 2021

With 2021 around the corner, the Orange Ulster School Districts Health Plan is excited to announce several Plan benefit Read More

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