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Self-Pay Retirees/Medicare Self-Pay Retirees / Medicare

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Coverage Continuation Coverage Continuation

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PRESCRIPTION

Express Scripts is still the Pharmacy Benefit Manager for the School Health Insurance Fund.
 
·        You will continue to have two ID cards; one for medical from Aetna and one for prescription from Express Scripts.

 

·        Prior Authorizations and Specialty Medications: 
         Any new prescriptions will require prior authorization.  If you are taking a Specialty Medication or a drug that requires prior authorization and you have a concern, contact Assured Partners for assistance.


·        Mail Order Program:
         If you would like to participate in the Express Scripts RX Mail Order program, you must obtain a new script from your doctor and enroll in Express Scripts Mail Order program. See below for more information on Mail Order.

 

·        If you have any question or concern, contact Assured Partners for assistance.

 

For Express Scripts - Get Started Member's Guide - Click Here


Express Scripts ID Cards

For instructions on how to print and retrieve virtual member ID cards, please - Click Here.

For a sample Express Scripts ID Card, please - Click Here.

For an Express Scripts Temporary ID Card, please -  Click Here.


Contacting Express Scripts

You will need to contact Express Scripts for; Mail Order, Prior-Authorizations, Formulary Options, Specialty medication.  Below is the member services number along with the website.

  • Member Services- (800) 467-2006

Express Scripts Mail Order Program

Express Scripts handles millions of prescriptions each year through home delivery from the Express Scripts Pharmacy.  The Express Scripts Home Delivery allows you to receive up to a 90 day supply of your long term medications, delivered to your home, for one copayment.  To get started, sign in at Express-Scripts.com or call the toll-free number on your ID card.

Which of my medications is ideal for Home Delivery (Mail Order)?                                                                                                                                                                                                                                                                    Use Home Delivery for your maintenance medications. For short-term illness requiring a one-time prescription, such as an antibiotic, your participating pharmacy is the best choice.

For FAQ's on Maintenance Medications - Click Here.


Express Scripts – Prior Authorization

Prior Authorization (PA) is a program that monitors certain prescription drugs to assure that the medication you are prescribed is the most safe and effective for your diagnosis.  

For more information on the Prior Authorization (PA) process and what kinds of drugs this process applies to - Click Here

For a list of medications on the Prior Authorization (PA) list - Click Here.


Accredco – Specialty Medications Provider

Specialty medications require special handling, careful administration, and ongoing patient care management. Accredo, an Express Scripts Specialty Pharmacy, has been working exclusively with specialty medications for more than 25 years. To get started, visit the Accredo website at www.accredo.com  or contact them at 1-877-ACCREDO (222-7336).

For more information regarding Accredo and Specialty Medications - Click Here.


Express Scripts Mobile App

Get prescription information delivered to your smart phone through the Express Scripts Mobile App. 

For more information -Click Here.


Express Scripts– How do I know if a drug is covered, or what the cost of my medication is?

Express Scripts covers all FDA approved drugs.  Members can save money by using generics or drugs that are on the preferred formulary list.  Below please find the Express Scripts Preferred Formulary list. Members can also call Express Scripts Member Services at (800) 467-2006 or visit the website at – www.express-scripts.com to get more information about a specific medication.

For a copy of the 2018 Express Scripts National Preferred Formulary - Click Here.


Express Scripts Participating Pharmacies

To locate a participating pharmacy, please contact Express Scripts at (800) 467-2006 or visit their website at www.express-scripts.com.

If you should have any questions or concerns about your prescription coverage, please contact Assured Partners.


Notice of Creditable Coverage
The Medicare Modernization Act (MMA) requires entities (whose policies include prescription drug coverage) to notify Medicare eligible policyholders whether their prescription drug coverage is creditable coverage, which means that the coverage is expected to pay on average as much as the standard Medicare prescription drug coverage. Accordingly, this information is essential to an individual’s decision whether to enroll in a Medicare.  For more information, please visit the Coverage Continuation tab.

Please remember your insurance benefits are limited to the terms, conditions, exclusions and limitations of the insurance carrier’s policy. Nothing contained on this website shall be deemed to have altered, waived, or extended the coverage provided by the policy. This overview contains a general description of your benefits program for your use as a convenient reference. Complete details of your program appear in the policy, which govern the benefits and operation of your program. The policy supersedes if there should be any inconsistency or difference between its provisions and the information in this overview.

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