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Express Scripts Medicare (PDP)

Express Scripts Medicare® (PDP) is a Medicare-approved Part D plan that is available nationwide and in Puerto Rico. Express Scripts Medicare offers two plans to suit your personal medication needs and budget:

  • The Value plan features a low monthly premium and $2 generic drugs (Tier 1) at retail network pharmacies.
  • The Choice plan features a $0 deductible, with $0 generic drugs (Tier 1) when you use the Express Scripts home delivery pharmacy, and $2 generic drugs (Tier 1) at our new preferred retail network pharmacies.*
When you enroll in Express Scripts Medicare, you get access to:
  • Express Scripts Medicare Advisors, who are available 24/7 to answer your questions, offer ways to help you save on the drugs you depend on, and suggest ways to delay entering the Coverage Gap stage
  • Express Scripts pharmacists, who watch out for your health and safety and are always available by phone to answer your questions - even in the middle of the night
  • Express Scripts specialist pharmacists, whose expertise in the medications used to treat specific conditions, such as diabetes, high blood pressure and high cholesterol, gives you greater peace of mind
  • More than 3,000 of the most commonly prescribed prescription drugs
  • A broad national network of more than 66,000 pharmacies, including national chains, independent retail pharmacies in your neighborhood, and the Express Scripts home delivery pharmacy

*Other pharmacies are available in our network. Preferred pharmacies may not be available in all areas. Those who receive low-income subsidy assistance (Extra Help) pay the same copayment as set by Medicare at any network pharmacy.

If you have Medicare and full Medicaid coverage: The Centers for Medicare & Medicaid Services (CMS) automatically enrolls you in a Medicare prescription drug plan each year if you meet the following criteria:

  • You are a full benefit dual-eligible (meaning you have both Medicare and Medicaid), are a Medicare Savings Program participant, or receive Supplemental Security Income (SSI); OR you applied and were approved for Extra Help, also called the low-income subsidy (LIS).
  • You have been automatically enrolled into a Medicare prescription drug plan in the past, and you continue to receive Extra Help in 2013.
  • You or your authorized representative did not voluntarily choose to enroll in another prescription drug plan.
  • Your current prescription drug plan has a premium in 2013 that is above the minimum amount required by CMS, or your Medicare prescription drug plan is terminating at the end of 2013.

If you were automatically enrolled in a plan other than Express Scripts Medicare, you are allowed to switch to Express Scripts Medicare if you choose to, but you will be responsible for paying any additional costs.

Please note: If you currently have prescription coverage through another plan, you may not need to join Express Scripts Medicare. You should speak to a representative who handles your current prescription benefit before making the decision to enroll. You cannot enroll in this program if you get drug coverage from a current or former employer or union that helps you pay for your drugs.

Need help finding the best option?

For general Customer Service, call an Express Scripts Medicare Advisor at 1.866.477.5703, 8:00 a.m. to 8:00 p.m., 7 days a week except Thanksgiving and Christmas. This information is available for free in other languages. TTY users should call 1.800.716.3231.

Or, if you prefer, follow the link below to learn more about Express Scripts Medicare. When you click on the link to our Medicare website, you will be leaving the Express Scripts member website. Please review the Terms of Use and Privacy Policy on the Express Scripts Medicare website.

If you're interested in learning more about Express Scripts Medicare, visit www.Express-ScriptsMedicare.com.

The benefit information provided is a brief summary, not a complete description of benefits. For more information, contact the plan. Limitations, copayments, and restrictions may apply. Benefits, formulary, pharmacy network, premium and/or copayments/coinsurance may change on January 1 of each year.

This page was last updated on 10/01/2013.
© Express Scripts Holding Company. All Rights Reserved.

Express Scripts Medicare (PDP) is a prescription drug plan with a Medicare contract. Enrollment in Express Scripts Medicare depends on contract renewal.