Express Scripts Pharmacy Coverage
The following will help to maximize your prescription drug coverage benefits:
- Use generic drugs whenever possible.
- If you are taking a brand-name drug that is not on your formulary, ask your doctor if a formulary drug or a generic would be right for you.
- Use your Home Delivery program for maintenance medications. Maintenance medications are prescription drugs that you take regularly to treat ongoing conditions like diabetes, high blood pressure and asthma. You can usually save time and money by using the Express Scripts Pharmacy to fill your maintenance medications.
- Use participating local pharmacies to fill your short-term prescriptions. For example, your doctor might prescribe a 15-day medication for an infection. You should always get these types of medications from a participating local pharmacy.
Note: The Price a Medication calculator does not imply a guarantee of coverage as covered products or categories are subject to individual plan restrictions and/or limitations. The Price a Medication tool displays cost and coverage information for the current calendar year.
Yes, effective January 1, your plan’s formulary (a list of preferred medications) will change. As a result, some preferred medications will become non-preferred, and vice versa. You may register on www.Express-Scripts.com to find out which medications are preferred. If you are taking a brand-name drug that is about to become non-preferred, you may want to talk to your doctor about a lower-cost option.
- Preferred (or formulary) medications are on the formulary and cost less than
non-preferred medications. This list of drugs is determined based on the
advice of pharmacists and a group of independent doctors.
- Non-preferred (or non-formulary) medications are not on your list of
recommended drugs and may cost you more.