Prescription Plan
Administered through Express Scripts*
Whatever medical plan you choose, you are automatically enrolled in the Prescription Drug Program.
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.
Prescription Co-Pays (HMO & PPO plans)
Retail (30-day supply)
Generic $10
Brand Formulary $30
Brand Non-formulary $50
Mail Order (90-day supply)
Generic $25
Brand Formulary $75
Brand Non-formulary $125
Prescription Cost (CDHP Plan)
Retail (30-day supply)
Certain preventive drugs covered 100%
(see Preventive medication list)
Preferred Brand-Name All other drugs, deductible then 20% coinsurance
Mail Order (90-day supply)
Certain preventive drugs covered 100%
(see Preventive medication list)
Preferred Brand-Name All other drugs,
deductible then 20% coinsurance
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 (PDST)
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 www.express-scripts.com. If you enroll in the CDHP plan, you can contact 1-855-315-3369.