Prescription plan highlights
Where can I find a summary of my prescription plan?
"Benefit highlights" is a summary of your pharmacy
benefit as provided by your health plan's prescription drug program, administered by Express Scripts. This at-a-glance overview shows when to use a participating retail pharmacy, and when it is recommended that you take advantage of the convenience of home delivery. "Benefit highlights" also displays the days' supply, co-pay, deductible and out-of-pocket expenses associated with using your prescription benefit plan. Once
logged in, you can access your "Benefit highlights"
from the left-hand menu bar in the "Prescriptions & benefits" section.
How should my doctor write my home delivery prescription?
To maximize your savings:
- Ask your doctor to write your prescription for a 90-day supply (or your plan's home delivery limit) with refills when appropriate instead of 30-day supply with refills.
- It is important to ask for a 90-day supply, as opposed to a 30-day supply, in order to receive up to 90 days of medication for one home delivery co-payment. Please note that you will be charged a home delivery co-payment regardless of the number of days' supply written on the prescription, so make sure your doctor has written the prescription for 90 days.
Please note that the actual quantity and/or days' supply may vary for each drug. Your doctor's instructions on how to take the medication, state and federal dispensing guidelines, or how the medication is packaged may impact the quantity and/or days' supply you can receive.
What does "days' supply" mean?
Days' supply refers to the number of days of medication
your physician prescribes. In most cases, your physician
will prescribe a 30-day supply when using a participating retail pharmacy.
For ongoing prescriptions, you can tell your physician that
you would like to use our home delivery pharmacy
and ask your physician to write your prescription for the
maximum days supply permitted by your plan. Note that while
each plan differs, most plans' maximum days supply when
taking advantage of home delivery is 90 days.
What is a co-payment?
A co-payment (co-pay) is the portion of the total cost of
the prescription that you must pay. Co-payments differ depending
on your plan's coverage and guidelines and are necessary
for new prescriptions, prescription refills and prescription
What is a deductible?
A deductible is the amount of covered charges you must assume/pay
before your health plan provider will permit your insurance
benefits to be paid.
What is an out-of-pocket expense?
An out-of-pocket expense is the amount that a covered person
must pay out of their own pocket, regardless of one's coverage.
Are there any differences in my benefits when using
home delivery versus a participating retail pharmacy?
If your benefit plan has a home delivery component, having
a larger days supply, such as a 90-day supply when using
home delivery, increases your convenience by shipping medications
to your door and by providing you the ability to use our
site to refill and renew your prescriptions online, anytime,
once you get started. Depending on your plan's guidelines,
taking advantage of your home delivery benefit could save
you money. Check your plan's specifics for details.
What if I've reviewed the information that you have displayed in "Benefit
highlights" and they seem to be different from what I thought they were?
Always check your plan's benefit materials should you need more details or have
questions. If you still need assistance, you can use our online form
to contact a member services representative or call toll-free
for more information.
How can I locate a participating retail pharmacy in my area?
Once logged in, you can locate a participating retail pharmacy in your area by clicking the "Locate a pharmacy" link located in the left-hand menu bar in the "Prescriptions & benefits" section. Next, follow the on-screen instructions
to enter a location using either a valid ZIP code or the city and state. When
entering the city and state please be sure to include a comma between the city
name and the state abbreviation.
What if I was unable to use my drug ID card to purchase a prescription at a participating retail pharmacy?
If your benefit plan allows, you can submit a claim for reimbursement. Your reimbursement claim will be considered based on what your plan approves.
You may submit a "Prescription Drug Reimbursement Form" if you have paid full price for a prescription drug order at a pharmacy because:
The "Prescription Drug Reimbursement Form" may be found on the Forms & Cards page.
- The pharmacy does not accept your prescription drug ID card
- You have not received your prescription drug ID card
- Your benefit plan requires you to submit a claim form for all your participating retail pharmacy purchases