Prescription Drug PlanOn this page
Overview The amount you pay for each prescription depends on whether the drug is a brand or generic medication, whether it appears on the formulary list of preferred medication, and whether it is purchased at a network pharmacy or through Express Scripts home delivery. The three-tiered copay benefit arrangement makes preferred drugs available to you at more attractive copays. You still have access to medications not on the formulary, but at the higher non-formulary copay. A formulary is a list of preferred medications that includes drugs that are safe, clinically effective and economical. The formulary list (PDF) was developed by an expert committee of independent pharmacists and physicians. These medications are clinically effective and cost-effective. You will save money by selecting preferred drugs from the formulary listing. Choosing medications not listed on the formulary will require you to share more of the cost in the form of a higher copay. In order to save money, you and your doctor should be aware of this formulary drug list and select from the medications listed. The prescription drug plan has a generics preferred policy to encourage participants to request generic drugs when available and appropriate. Choosing generic drugs and paying the lower copay is the most cost-effective way to help control the rising costs of prescription drugs. Here is how it works: For all prescriptions filled by home delivery and network pharmacies, Express Scripts' policy is to fill a prescription with the generic equivalent drug unless the prescription specifically states, "do not substitute." Prescriptions where the physician has specified DAW (dispense as written) will be filled with the brand drug. If DAW is not noted, Express Scripts will automatically dispense a generic equivalent drug. If you choose a brand drug when a generic equivalent is available or your physician has specified DAW, you will pay the brand copay plus the cost difference between the brand drug and the generic drug. Take note of the special savings by using the Express Scripts home delivery. Order or refill your 90-day supply of maintenance drugs pay just one copay and your prescriptions are shipped free of charge to your home address. Filling the same prescription at a network pharmacy would require three 30-day supplies and three copays. Enjoy additional savings by asking your pharmacist if a generic equivalent drug is available for your prescription. If you anticipate a lot of prescription drug expenses, you should consider opening a Health Care Spending Account. This allows you to save money to pay for predictable medical expenses. Select Home Delivery Program Select Home Delivery is an ongoing program focused on convenience and cost-savings for you and the company. If you decide to opt out of home delivery and continue filling your maintenance prescription at the retail network pharmacy, Express Scripts will contact you again in 12 months to see if you would like to start home delivery. It's easy to start home delivery. Visit www.StartHomeDelivery.com or call 888-772-5188. If you choose to move your maintenance prescription to home delivery, Express Scripts will call your doctor to get a new prescription and walk you through the process. Step Therapy Program Specialty Medications
Specialty medications covered under your prescription drug plan require a 20 percent copay with a maximum out-of-pocket of $150 per prescription. Your annual maximum out-of-pocket for specialty medications will be $2,000 per member and $4,000 per family. The maximum days supply for your specialty medications is 30 days. To learn more about specialty medications, read the online brochure (PDF). To reach CuraScript Specialty Pharmacy, call 866-848-9870. Need to find out the price of a prescription? Once you have registered, go to Express Preview for 2010 (https://member.express-scripts.com/preview/ehi2010) |
Forms, Resources and Web Sites
Prescription Drug Claim Form(PDF)
Prescription Order Form (Mail-In)(PDF)
Prescription Order Form (Fax-In)(PDF)
Formulary Drug List(PDF)
Detailed Formulary Drug List (PDF)
Benefit Issue Resolution Request Form (PDF)
Notice of Privacy(PDF)
These forms require the use of Adobe Acrobat Reader®. Download it for FREE!
1-866-291-2607
Related Information:

