How Does the Plan Pay for Prescriptions?
Did you know your Health Plan gives you several options to fill prescriptions? Your benefit coverage and out-of-pocket costs vary (see chart at right), so it pays to know your choices.
- Generic vs. Brand Name. Always ask if a generic alternative is right for you. You’ll save money with the lowest copay for a dependable drug that has been in use for many years.
- Preferred vs. Non-Preferred Brand-Name Drugs. Preferred brand-name drugs are chosen by an independent committee of health care professionals, based on the drug’s safety and effectiveness. Ask your doctor to choose from this list, if possible in your situation, and you’ll save money with a lower copay.
- Participating vs. Non-Participating Pharmacy. When you choose a participating pharmacy, simply show your ID card and pay your copay. Participating pharmacies charge a discounted rate, saving money for you and the Trust. At a non-participating pharmacy, you pay the full price, then submit a claim for reimbursement; however, you pay any amount that exceeds the discounted rate.
- Mail Order vs. Retail. For prescriptions you take regularly, try Mail Order. You’ll save money with a 90-day supply and enjoy convenient, free home delivery. Find out how to get started at Express-Scripts.com.
2018 Active Plan Prescription Copays
|Retail Copays||Mail Order Copays|
|Number of Days Supply||Up to a 30-day supply||Up to a 90-day supply|
|Generic||You pay $10 (20%, up to to $20, until 12/31/2017)||You pay 20%, up to $40|
|Preferred Brand||You pay 20%, up to $40||You pay 20%, up to $80|
|Non-Preferred Brand||You pay 20%, up to $65 (up to $60, until 12/31/2017)||You pay 20%, up to $120|
|Specialty||You pay $60||You pay $60|
Get the Express Scripts App
Download the free Express Scripts app on your smartphone. The app makes it easy to access your ID card, find a participating pharmacy, view the Preferred Brand-Name drug list, manage refills and much more.