Whichever medical plan you choose to enroll in, you will be automatically enrolled in the Prescription Plan administered by Express Scripts.
HMO AND PPO PLANS
|Generic||Brand Formulary||Brand Non-Formulary|
|Retail (30 day supply)||$10||$30||$50|
|Mail Order (90 day supply)||$25||$75||$125|
|Preventive Drugs (see list)||Preferred Brand Name|
|Retail (30 day supply)||100% covered||Deductible, then 20% co-insurance|
|Mail Order (90 day supply)||100% covered||Deductible, then 20% co-insurance|
This program uses the formulary that parallels the following three-tier program used by Express Scripts. A formulary is a list of prescription drugs covered by a particular drug benefit plan.
- GENERIC Purchasing generic drugs allows you to pay a lower out-of-pocket cost than if you purchase formulary or non-formulary brand name drugs. Generic drugs are chemically identical to their brand-name counterparts.
- BRAND FORMULARY The brand formulary is an approved, recommended list of brand-name medications. Drugs on this list are available to you at a lower cost than drugs that do not appear on this preferred list.
- BRAND NON-FORMULARY You may purchase brand-name medications that do not appear on the recommended list, but at a significantly higher out-of pocket cost.
Incentivized Mail Order Program (applies to the HMO & PPO plans)
Members that utilize maintenance medication will receive a financial incentive to have their medication filled through Mail Order instead of a Retail Pharmacy. The prescription will provide a 90-day supply and the co-pay will be less than you would pay over 90 days at a Retail Pharmacy.
Preferred Drug Step Therapy
Members will be required to try a generic drug before utilizing a brand name drug. In most cases, the generic alternative is chemically equivalent. In the event that you have tried the generic in the past and it does not work for you, the physician has the ability to contact Express Scripts with a prior authorization.
For more information, please feel free to contact Express Scripts at 1-800-711-0917 or the Express Scripts website. If you enroll in the CDHP plan, you can contact 1-855-315-3369.