- How do I fill a prescription?
- Show your new ID card to a participating pharmacy. These pharmacies have agreed to charge a discounted amount. Most major pharmacy chains participate in the pharmacy network. To locate a participating pharmacy, check www.express-scripts.com or call Customer care at 1-866-275-0044.
- How do I get a new ID card?
- Contact Allied 1-800-288-2078 or click on Get ID Card.
- How do I start using home delivery for my new prescriptions?
- Ask your doctor to write a new prescription for a 90-day supply, plus appropriate refills for up to one year. Write card member ID number, patient name, and patient date of birth on the back of your prescription. Mail the completed profile form and prescription(s) to Express Scripts, Inc., PO Box 1007, Bensalem, PA 19020-1007. If you need the medication immediately, ask your doctor for one short-term 30-day supply script that you may fill at the retail pharmacy so you have a supply until the 90-day supply arrives. Physicians may fax new mail order scripts to 1-800-636-9494.
- How long does it take the Express Scripts’ Pharmacy facility to fill a new prescription?
- You should receive your prescription at home within 10 to 14 business days after you mail your prescription to Express Scripts.
- How do I order refills through Home Delivery?
- You may order your next refill when you have 34-days worth of your current medication remaining. This 34 day window allows Express Scripts to send you your medications before you run out.
The fastest ways to order refills are: Go to www.express-scripts.com and activate your account. You can then order online. Phone 1-866-275-0044 for 24-hour customer service.
You can also send your refill by mail using the envelope you received with your order.
- What if I need a Home Delivery order form?
- Go to www.express-scripts.com and follow the instructions to print one, or call the toll-free number on the back of your ID card to request an order form.
- How soon can I get a refill on my mail service pharmacy prescription?
- You may order your refill when you have 34 days or less of your current medication remaining. This will allow Express Scripts to send you your drugs before you run out.
- Which of my prescription drugs can be filled using Home Delivery?
- You may use Home Delivery for prescriptions you take every day for a long period of time. For a short-term illness requiring a one-time prescription (and no refills), such as an antibiotic, a retail pharmacy in your network is the best choice.
- Does the Express Scripts Pharmacy have easy-open bottle caps available?
- Yes. Express Scripts ships prescriptions with child-resistant safety caps, but you may request easy-open caps, if that’s what you prefer.
- I take medicine that needs to be refrigerated? Can I still use Home Delivery?
- Yes. The Express Scripts Pharmacy will ship drugs requiring refrigeration in cold packs.
- How do I know which pharmacies I can use to fill my prescriptions?
- With the Express Scripts program, participating retail pharmacies are easy to find. You can visit www.express-scripts.com and use the Pharmacy Locator to find a list of pharmacies closest to you. If you don’t have access to a computer, please call the toll-free number on the back of your ID card and a representative will tell you which pharmacies are near you.
- Where can I get additional information about my prescription drug benefit?
- What if I choose a brand name drug with a generic available?
- If you get a brand drug when a generic is available, you will pay the cost of the generic plus the cost difference between the brand and generic drug. If you have an annual prescription out-of-pocket maximum, the cost difference does not count toward your out-of-pocket. You will pay the difference between the cost of the generic and brand.
- What is a Formulary Drug List?
- The Formulary Drug List is a list of prescription drugs that are therapeutically sound, available and offer the best health outcomes at an affordable cost. New drugs and the current list are constantly monitored and reviewed by a panel of practicing doctors and pharmacists for safety, effectiveness and affordability. Your copay for a formulary drug is less than your copay for a non-formulary drug. If you have a prescription out-of-pocket, the non-formulary copay does not count toward your prescription out-of-pocket maximum.
- How does my doctor know what drugs are on the formulary?
- • The Preferred Formulary Drug List is distributed to participating doctors and pharmacies.
• A list is mailed to your home annually.
• Ask your doctor to review and select the appropriate medication for you from the formulary list. If your doctor has any questions about the Formulary, he/she may call Express Scripts at 1-866-275-0044.
- My medication is not listed on the Preferred Formulary List? What should I do?
- • The Preferred Formulary list is just a summary.
• For the complete list, call Express Scripts at 1-866-275-0044 or visit www.express-scripts.com.
• The formulary is not mandatory, but a non-formulary drug copay costs more money. You pay the highest cost share for non-formulary drugs.
- A drug that I have taken for two years is not on the formulary list. Can I continue with my drug at the higher benefit level?
- • If your physician determines that there are medical reasons why you should remain on a non-formulary drug, he/she may contact Express Scripts at 1-866-275-0044.
- How do I determine when to have my prescriptions filled through the home delivery service pharmacy?
- BHP Classic members must use mail order for maintenance medications. You may call Express Scripts customer service at 1-866-275-0044 or visit www.express-scripts.com to determine if you are on a maintenance medication. When you have a maintenance medication filled for the first time at a retail pharmacy, you will get a letter letting you know you have only two (2) refills remaining at retail and any additional refills will need to be filled through mail service. This applies to all maintenance or long-term medications for conditions such as diabetes, arthritis, heart conditions, high blood pressure, etc. Your local network pharmacy can be used for short-term or acute medication needs such as antibiotics or pain relief medications.
- What is the Specialty Pharmacy?
- Specialty Pharmacy has the experience to manage chronic conditions and will work closely with you and your physician’s office to arrange delivery of your specialty medications. The specialty pharmacy offers a full complement of specialized prescription drugs and services for patients with: hepatitis, cancer, infertility, growth deficiency, rheumatoid arthritis, Crohn's disease, multiple sclerosis, RSV, hemophilia, organ transplant, and HIV/AIDS.
The benefits of using the program include the following:
- Free home delivery of up to a 30-day supply of your medication (retail copay applies)
- Ready access to a staff of pharmacists, nurses and care coordinators who are trained specialists on the medications provided and the conditions being treated
- Educational material, support or home instruction available
- Ancillary supplies such as syringes and needles
- A higher level of coordination of care with your physician
For more information call CuraScripts at 1-866-848-9870.
- What drugs are covered?
- Covered Prescription Drugs: Except for excluded items, the Plan covers drugs that, by law, may be dispensed only by prescription and that fall within one of the following categories:
1. Federal (United States) Legend Drugs (including oral and injectable contraceptives),
2. State restricted drugs, or
3. Compound drugs that contain at least one Prescription Legend Drug.
Covered Pharmaceutical Products: The Plan also covers insulin, diabetic testing devices, test strips, syringe, and needles.
- What drugs are not covered?
- Check your medical plan document for more information.
Drugs and Pharmaceuticals Not Covered: The Plan does not pay for any of the following medications or pharmaceutical products:
1. Any covered drug in excess of the quantity specified by the Physician, or any refill dispensed after one year from the Physician’s order
2. Any device or appliance (e.g., orthotics and other non-medical substances)
3. Diagnostic medications
4. Experimental drugs
5. Fluoride preparations
6. Gold Compounds – prepared with raw chemical ingredients, or legend drugs prepared in a non-FDA approved dosage form
7. Irrigation solutions
8. Medications furnished on an inpatient basis covered under any other carrier providing group coverage for prescription legend drugs or insulin through Coordination of Benefits provision (e.g. major medical, home health care benefits, outpatient benefits)
9. Medical supplies (e.g. Ostomy Supplies)
10. More than a 30-day supply of a covered Drug
11. More than a 90-day supply of a covered Maintenance Drug
12. Over-the-counter products
13. Pharmaceutical products used for cosmetic purposes
14. Prescription vitamins, except pre-natal
15. Serums, toxoids, and vaccines
16. Smoking cessation products (See “What Is Covered” —“Smoking/Tobacco Cessation”)
17. Therapeutic devices or appliances
18. Yohimebine
