Prescription Rx

If you are enrolled in an HMO or EPO Medical Plan, your prescription drugs are covered by the HMO or EPO Health Plans. If you are enrolled under the Fee for Service PPO Medical Plan, your prescription coverage is under the Express Scripts Plan. Under the Express Scripts Plan, you may take your prescription to a participating pharmacy or you may use the Express Scripts mail order pharmacy.  To contact Express Scripts, call (800) 987-7836 or visit www.express-scripts.com

Important: After the second purchase of a long-term drug at a participating retail pharmacy,you'll pay the entire cost if you continue to purchase that medication at retail. (Long-term drugs are those you take to treat an ongoing condition, such as high blood pressure or high cholesterol.) If you don't want to pay the entire cost for your long-term drugs, get them by mail from the Express Scripts Pharmacy. Not only will you save, you can also get up to a 90-day supply of your medication delivered right to you—with free standard shipping! Express Scripts knows that mail order may be new to you, so they make it easy.

To get started, call Express Scripts and let them do all the work. For most medications, they’ll be able to contact your doctor and arrange for your first mail-order supply. Your medication will usually arrive within 8 days after they get your doctor's approval. You should continue to use a participating retail pharmacy for short-term drugs, such as antibiotics.

Type of Drug Participating Retail Pharmacy Co-Payment up to a 30-Day Supply Express Scripts By Mail Co-Payment up to a 90-Day Supply
Generic 100% with a $10.00 Maximum $25.00
Preferred Brand 100% with a $40.00 Maximum $100.00
Non-preferred Brand 100% with a $60.00 Maximum $150.00
Preferred/Non-Preferred Brand For Which There is a Generic Equivalent Available You will be charged the brand co-payment, plus the difference in cost between the brand and the generic You will be charged the brand co-payment, plus the difference in cost between the brand and the generic

Note

Using preferred drugs helps control costs for you and your Plan while still providing you with the medications you need to stay healthy.

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