Who is Express Scripts?
Express Scripts is one of the nation’s largest prescription drug benefit managers and the largest mail-order pharmacy in the world. Beginning July 1, 2006, Express Scripts will administer your prescription drug benefit. With Express Scripts, you receive: pharmacy customer service 24 hours a day, 7 days a week (except Thanksgiving and Christmas); access to a pharmacist to answer your drug questions; excellent mail-order service; and access to an extensive network of participating pharmacies.
How do I find a participating retail pharmacy?
Visit the Express Scripts Pharmacy section of our site or call Express Scripts Member Services toll-free at 1-800-939-3751 to find a pharmacy near you.
Do I have to let my pharmacy know about Express Scripts?
No, we will advise participating pharmacies about the selection of Express Scripts as our prescription drug benefit manager. However, we will send you a new member identification card in June which lists the information pharmacies need to submit your drug claims to Express Scripts. Please present your new card to the pharmacy beginning July 1. Note: you will only receive a new card if you have a prescription drug benefit.
How do I know if my medication is covered or if there is a generic version of my brand drug is available?
The HealthNow Medication Guide includes a wide selection of brand-name and generic medications. Your specific drug benefit determines whether you need to use the Medication Guide, as well as your coverage and copayment for drugs on the guide. For the most up-to-date version of the Medication Guide, visit the Express Scripts Pharmacy section of our site.
Why should I use generic medications?
Although generic drugs may differ in color, shape, and size, they are manufactured according to the same strict federal guidelines for quality. Generic drugs also contain the same active ingredients as their brand-name counterparts. However, they typically cost much less than brand-name medications and can save you money
My doctor feels that I should use a non-formulary drug. Will a non-formulary drug be covered?
Your doctor can submit a Prior Approval/Non-Formulary Request form to ask that a non-formulary medication be covered. Most physician offices have these forms which are also available on our web site.
My drug requires prior authorization. What does that mean?
Certain medications require your physician to obtain approval from HealthNow before prescribing. We review medical and pharmacy information provided by providers to determine if clinical guidelines have been met and confirm that the medication is being used appropriately.
How do physicians obtain prior authorization?
Your doctor simply faxes a Prior Approval/Non-Formulary Request Form to HealthNow. Most physicians have these forms in their offices.
What is the supply limit for my medication?
You may receive up to a 30- or 34-day supply (depending on your specific drug benefit) of medication from a participating retail pharmacy. For medications you take on an ongoing basis, you should ask your doctor to prescribe up to a 90-day supply, plus refills for up to 1 year (as appropriate) to be filled through Express Scripts By Mail, Express Script’s mail-order pharmacy.
Who has access to my prescription information?
Express Scripts protects your privacy. Because your privacy is important to us, Express Scripts fully complies with federal privacy regulations. Express Scripts uses health and prescription information about you and your dependents to administer your plan and to fill your mail-order prescriptions.
What is Express Scripts By Mail?
Express Scripts By Mail is your mail-order pharmacy. It’s a convenient way for you to order and receive your long-term medications, and you may pay less over time for these prescriptions. Express Scripts follows strict quality and safety controls for every prescription filled, and its pharmacies are staffed with registered pharmacists.
Why should I use mail order?
Mail-order is a convenient way for you to order and receive your long-term medications. Through mail-order, you can obtain a 90-day supply of a medication, compared with the 30- or 34-day supply you can get at a retail pharmacy. Your mail-order benefit may also have a lower copayment for mail-order prescriptions than for retail prescriptions, so you may save money.
How do I know what my mail-order copayment is?
Your mail-order copayment is listed in your member guide or other plan documents. Customer Service can also advise you about your mail-order copayment. Call us at the number on the back of your identification card
How do I begin using Express Scripts By Mail?
To get started using Express Scripts By Mail, ask your doctor to write a prescription for up to a 90-day supply, plus refills for up to 1 year (if appropriate). To fill the prescription you may:
- Mail your prescription(s) using a Express Scripts By Mail order form and required copayment.
- Ask your doctor to call 1-888-327-9791 for instructions on how to fax your prescription.
- Order online by registering for Express Scripts Online Member Services.
How do I order refills through Express Scripts By Mail?
You can order a refill either through Express Scripts Online Member Services by calling toll free 1-800-4 REFILL (1-800-473-3455). You may also use the refill order form that will accompany your prescription. Mail it with your copayment to Express Scripts in the return envelope. To make sure you don’t run out of your medication, remember to re-order 14 days before your medication runs out. You can find the refill date on your prescription bottle or on the refill slip that comes with every order.
How soon will I receive my mail-order prescription and how can I check the status of my order?
Your medication will usually be delivered within 8 days after we receive your order. To check on the status of your order, enroll in Express Scripts Online Member Services or call Express Scripts Member Services at 1-800-939-3751
How do I pay for my mail-order prescriptions?
Express Scripts has a safe, convenient way for you to pay for your orders called e-check. E-check is an electronic funds transfer system that automatically deducts your copayment from your checking account. For more information or to enroll online, call Member Services toll free at 1-800-939-3751 or access Express Script’s web site by registering for Express Scripts Online Member Services.
If you prefer to pay for all your orders by credit card, you may want to join Express Script’s automatic payment program. To enroll, call toll free 1-800-948-8779.
Will I pay for shipping when I use mail order?
No, there is no charge to you for standard shipping. If you request it, expedited shipping is available for an extra charge.
Do I get the same quality of prescription drugs that I get at a participating retail pharmacy?
Whether you use brand-name or generic drugs, you can expect that the medication from Express Scripts By Mail is of the same quality as those you currently use.
How do I request order forms and envelopes?
You can request Express Scripts By Mail order forms and envelopes online by visiting the Express Scripts Pharmacy section of the web site. You can also call Express Scripts toll free at 1-800-939-3751
What if I need to speak with a pharmacist?
Just call toll free 1-800-939-3751. Express Scripts pharmacists are available for consultation 24 hours a day, 7 days a week.
Why should I use mail order?
Mail order is a convenient way for you to order and receive your long-term medications. Through mail order, you can obtain a 90-day supply of a medication, compared with the 30- or 34-day supply you can get at a retail pharmacy. Your mail-order benefit may also have a lower copayment for mail-order prescriptions than for retail prescriptions, so you may save money.
How do I know what my mail-order copayment is?
Your mail-order copayment is listed in your member guide or other plan documents. You can also call Express Scripts Member Services to ask about your mail-order copayment or you can register for Express Scripts Online Member Services to access copayment information on the Express Scripts site.
What is the difference between long-term and short-term drugs?
Long-term drugs are those that you take on an ongoing basis, such as those used to treat high blood pressure or high cholesterol. Long-term drugs are also called maintenance medications. Short-term drugs include antibiotics and other medications that you take for short periods of time. You should continue to get all your short-term drugs, such as antibiotics, at a participating retail pharmacy. You’ll continue to pay your participating retail pharmacy copayment for short-term drugs.